Addressing Mitral Regurgitation in High-Risk Patients: Comparison of Approaches

Despite many design limitations, this study suggests that a transcatheter or surgical approach to secondary MR in high-risk patients improves survival.

The treatment of severe mitral valve regurgitation (MR) in patients at high surgical risk, particularly if the etiology is secondary (i.e., functional), is controversial because evidence is lacking that repair improves survival. Most high-risk patients are treated conservatively. In an observational study from the Netherlands, investigators compared survival of 139 consecutive patients treated with transcatheter mitral valve repair with the MitraClip system to survival in 112 historical control patients — 53 treated with surgery (valve replacement or repair) and 59 managed conservatively. Two authors report a connection with the manufacturer's training facility.

All patients were considered high-risk by the local heart team; the mean log Eur…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)