Full Description
Mitral regurgitation (MR) affects millions of patients worldwide. It is a progressive condition that can worsen when left untreated, possibly leading to compensatory remodeling of the left ventricle. This can result in reduced functional capacity, poor quality of life, repeat hospitalizations, and even death from heart failure. Open, arrested heart surgery has until now been the therapeutic treatment of choice. However, many high-risk patients cannot tolerate traditional heart surgery and continue to suffer from severe MR.
In Percutaneous Mitral Leaflet Repair: MitraClip Therapy for Mitral Regurgitation, international experts discuss the clinical application of percutaneous mitral valve therapies for this subsect of patients, focusing on the MitraClip device. These new therapeutic developments will form an essential component of the interventional cardiologists' armamentarium in treating MR patients and will be of interest to every practicing cardiologist.
Key topics include:
An overview of the anatomy and pathophysiology of the mitral valvular complex and MR
EVEREST trial outcomes, and the development of percutaneous edge-to-edge repair
Updates on the global experience with this new therapy
Patient selection and the role of percutaneous therapies for high-risk patients
Echocardiographic guidance, including practical tips for the use of transesophageal echocardiography during a procedure
Step-by-step techniques, plus tips and tricks for getting the best results for your patients
Special considerations for treating the returning MR repair patient
Discussion of the European experience since CE approval
Future directions in percutaneous mitral valve therapies
Contents
Preface 1. Anatomy of the mitral valvular complex 2. The pathophysiology of mitral regurgitation 3. Genesis of the surgical edge-to-edge repair 4. Outcomes from surgical edge-to-edge repair 5. An overview of the literature on surgical mitral valve repair 6. Development of percutaneous edge-to-edge repair: The MitraClip® Story 7. MitraClip® system design and history of development 8. The EVEREST trial results 9. Outcomes for functional mitral regurgitation 10. The role of percutaneous mitral repair for high risk patients 11. Echocardiographic evaluation for mitral regurgitation grading and patient selection 12. Understanding the limits of patient selection for edge-to-edge repair 13. The basic technique for the Evalve MitraClip® procedure 14. Procedural tips and tricks 15. Training and simulation 16. Special techniques for functional mitral regurgitation 17. The European experience since CE approval 18. An interventionalist's approach to the practical use of TEE guidance 19. Echocardiographic guidance of MitraClip® mitral valve repair 20. A critical appraisal of edge-to-edge repair with the MitraClip® 21. Technique for surgical removal of the MitraClip® 22. Special considerations for mitral valve repair after clip therapy 23. Gross and histologic findings after MitraClip® placement 24. Future directions in percutaneous mitral therapy
