Left Cardiac Chambers Reverse Remodeling after Percutaneous Mitral Valve Repair with the MitraClip System

Advances in echocardiography: insights into the mitral valve and implications for surgical and percutaneous repair

“…Moreover, the MitraClip was less effective in patients with enlarged preprocedural MA, which is in agreement with the previously published surgical reports showing that the edge-to-edge repair is less effective in presence of significant MA dilation. Similar findings were also reported by Scandura et al, who demonstrated that the MitraClip system led to left cardiac chamber reverse remodeling, with significant improvement in LV size and function, similarly to what was observed in surgical restoration [50]. All of these results future science group REVIEW Maffessanti, Tamborini, Fusini et al support the importance of 3D imaging for preprocedural patient selection and prediction of procedural effectiveness.…”

“…The application of this morphological analysis, completely based on RT3D echocardiography and otherwise unfeasible, to the settings of PMVR would add important information during patient selection but also in outcome evaluation phases. Encouraging results on positive reverse LV remodeling following PMVR have been proven by Scandura et al, who demonstrated a substantial reduction of LV end-diastolic and -systolic volumes 6 months after MitraClip implantation, which was associated with a significant improve ment in LV ejection fraction and decrease in LV sphericity, as evaluated by 2D TTE [50].…”

Assessment of Biventricular Function by Three-Dimensional Speckle-Tracking Echocardiography in Secondary Mitral Regurgitation after Repair with the MitraClip System

“…6,9,21,36,37 We found an improvement in the volume-overload state of MR as well as beneficial effects on LV wall stress and strain. It has been shown that patients with functional MR have more marked reductions in end-systolic volume compared with those with degenerative MR, 6,36 because they benefit more from the favorable unloading effect on the wall stress because the volume overload adds a greater pathologic burden to an already compromised ventricle.…”

“…[1][2][3][4][5][6] The clip implantation over the leaflets creates a double-orifice valve and thus mimics Alfieri's surgical procedure. The Endovascular Valve Edge-to-Edge Repair Study was the first randomized controlled study to show higher safety, lower clinical efficacy, and the same improvement in clinical outcome in comparison with surgical MV repair.…”

The MitraClip Experience and Future Percutaneous Mitral Valve Therapies

“…In DMR, the effect of MR on the LV is predominantly volume overload, which can be reversed by reducing or abolishing MR. In FMR, in which heart failure may be secondary to severely impaired myocardial contractility, positive LV remodelling with an increase in LVEF and CI may be less likely [12].…”