Percutaneous edge to edge mitraclip therapy in the management of mitral regurgitation

Mitral valve regurgitation (MR) is an important clinical issue as MR represents >30% of native valve diseases. Patients with symptomatic MR have a poor prognosis, with a 5% annual mortality rate in the absence of surgery. Optimal medical management can improve symptoms of heart failure but does not affect survival. Therefore, surgery is recommended by the current guidelines for patients with symptomatic severe MR or asymptomatic severe MR with evidence of left ventricular (LV) dysfunction or dilation. Despite guidelines, a recent European survey established that one-half of the patients are not referred for surgery, mainly because of advanced age and the presence of comorbidity. Mitral valve (MV) repair is the preferred surgical strategy whenever feasible and is associated with lower morbidity and mortality and better preservation of LV function, compared with MV replacement . Reported in-hospital mortality rates range from 1% to 2% in low-risk patients, increasing up to 25% in high-risk or elderly patients. Therefore, new percutaneous techniques are developed to avoid surgery in high-risk patients