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Echocardiography. 2017 Aug;34(8):1122-1129. doi: 10.1111/echo.13592. Epub 2017 Jun 7.

Prevalence of optimal valve morphology for MitraClip in patients with mitral regurgitation.

Author information

1
Center for Research on Cardiovascular Diseases (CIBERCV), Hospital Ramon y Cajal, University Alcala, Madrid, Spain.
2
Cardiology Department, Hospital Reina Sofia, Cordoba, Spain.
3
Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
4
Cardiology Department, Hospital Clinic, Thorax Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.
5
Cardiology Department, Hospital Virgen de la Victoria, Malaga, Spain.
6
Cardiology Division, Department of Medicine, Hospital de Sant Pau I de la Santa Creu, Universidad de Barcelona, Barcelona, Spain.
7
Cardiology Department, Hospital Virgen del Rocío, Sevilla, Spain.
8
Cardiology Department, Hospital Clinico, Santiago de Compostela, Spain.
9
Cardiology Department, Hospital de León, León, Spain.
10
University Francisco de Vitoria, Hospital La Zarzuela, Madrid, Spain.

Abstract

AIMS:

To evaluate how often patients with moderate-to-severe or severe mitral regurgitation (MR) meet the anatomical criteria for MitraClip implant and to examine the role of transthoracic echocardiography (TTE) for this task.

METHODS AND RESULTS:

From February to June 2015, all patients undergoing a TTE in nine Spanish hospitals were prospectively included. Patients with moderate-to-severe and severe mitral regurgitation were selected for analysis. Anatomical eligibility criteria for MitraClip were defined according to the EVEREST trial. A total of 39 855 consecutive TTE were reviewed, and 1403 patients with moderate-to-severe and severe MR were finally included. Primary MR was found in 779 patients (56%). Only in 74 patients (16%), all anatomical criteria for MitraClip could be assessed by TTE. Of these, 56% of patients had optimal valve morphology. Secondary MR was described in 361 patients (26%), and at least 249 of these (69%) had a high surgical risk. All five criteria for MitraClip were adequately assessed by TTE in 299 patients (83%). Of them, 118 patients (39%) had optimal valve morphology.

CONCLUSIONS:

A considerable proportion of patients have optimal mitral valve morphology for MitraClip. Moreover, TTE was particularly useful in determining whether or not the anatomical criteria for MitraClip implant were met in the majority of patients with secondary MR but in only a minority of those with primary MR.

KEYWORDS:

echocardiography; mitral regurgitation; percutaneous intervention

PMID:
28589566
DOI:
10.1111/echo.13592
[Indexed for MEDLINE]

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