Review of the Clinical Experiences with the MitraClip Therapy

Mitral regurgitation (MR) is the most frequent valvular heart disease in developed countries. MR can be organic or functional. The natural history of severe MR is unfavourable, leading to worsening left ventricle (LV) failure, pulmonary hypertension, atrial fibrillation and death. Surgical repair represents the optimal treatment for severe degenerative MR (DMR). By contrast, surgical correction of functional MR (FMR) is controversial, because the prognosis for the patient is related more to the cardio myopathic process than to MR. Outcomes after surgical correction of FMR remain suboptimal in many cases, and perioperative mortality is not negligible. Over the past few years, new transcatheter techniques have been developed to treat MR with less invasive approaches. Currently, the procedure with the widest clinical experience is the percutaneous edge-to-edge procedure performed with the MitraClip System (Abbott Park, IL, USA). Up until now, over 20 000 patients have been treated worldwide, with an increasing number of procedures in Europe and in Switzerland. Primary and secondary MR are very different entities in terms of aetiology, prognosis and management, and they will therefore be discussed separately in this review.