Transcatheter Valve Repair for Patients With Mitral Regurgitation

Lim, D. Scott; Kar, Saibal; Spargias, Konstantinos; Kipperman, Robert; O’Neill, William W.; Ng, M.; Fam, Neil; Walters, D.; Webb, John G.; Smith, Robert L.; Rinaldi, Michael; Latib, Azeem; Cohen, Gideon; Schäfer, Ulrich; Marcoff, Leo; Vandrangi, Prashanthi; Verta, Patrick; Feldman, Ted

doi:10.1016/j.jcin.2019.04.034

Cited by 146 publications

(91 citation statements)

References 28 publications

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“…After a favourable initial experience for compassionate use, PASCAL has been demonstrated to be safe and effective enough for clinical use in the CLASP prospective multicenter cohort study. 62 patients have been included in the CLASP cohort, with both degenerative and functional MR, and observed a low 1.6% cardiovascular mortality, without any stroke events and a 98% rate of < 3+ MR at 30 days [20,21] (Table 2, Fig. 1).…”

Section: Edge-to-edge Transcatheter Mitral Valve Plastymentioning

confidence: 99%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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Background: While rheumatic mitral stenosis has been effectively treated percutaneously for more than 20 years, mitral and tricuspid regurgitation treatment appear as a contemporary unmet need. The advent of transcatheter therapies offer new treatment options to often elderly and frail patients at high risk for open surgery. We aimed at providing an updated review of fast-growing domain of transcatheter mitral and tricuspid technology. Main body: We reviewed the existing literature on mitral and tricuspid transcatheter therapies. Mitraclip is becoming an established therapy for secondary mitral regurgitation in selected patients with disproportionately severe regurgitation associated with moderate left ventricle dysfunction. Evidence is less convincing for primary mitral regurgitation. Transcatheter mitral valve replacement is a promising emerging alternative to transcatheter repair, for secondary as well as primary mitral regurgitation. But further development is needed to improve delivery. Transcatheter tricuspid intervention arrives late after similar technologies have been developed for aortic and mitral valves and is currently at its infancy. This is likely due in part to previously under-recognized impact of tricuspid regurgitation on patient outcomes. Edge-to-edge repair is the most advanced transcatheter solution in development. Data on tricuspid annuloplasty and replacement is limited, and more research is warranted. Conclusion: The future appears bright for transcatheter mitral therapies, albeit their place in clinical practice is yet to be clearly defined. Tricuspid transcatheter therapies might address the unmet need of tricuspid regurgitation treatment.

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Section: Edge-to-edge Transcatheter Mitral Valve Plastymentioning

confidence: 99%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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“…The CLASP study was the first study evaluating the PASCAL system. 43) It was a prospective single-arm study which demonstrated excellent MR reduction (MR grade ≤2+ and ≤1+ were 98% and 86%, respectively) and significant functional improvement at 30-days. Randomized controlled trials pitting PASCAL with the MitraClip system are currently underway in the CLASP IID (DMR) and CLASP IIF (FMR) studies.…”

Section: Pascalmentioning

confidence: 99%

Percutaneous Edge-to-Edge Mitral Valve Repair

Yeo

Wong

2020

Korean Circ J

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Percutaneous edge-to-edge mitral valve repair, using the MitraClip device for severe mitral regurgitation (MR) was first introduced in 2003. Since then, more than 100,000 cases have been performed worldwide and it remains the most established percutaneous therapy available for the treatment of severe MR. Currently, it is indicated for severe, symptomatic functional MR in patients who continue to have significant symptoms despite optimal guideline directed medical therapy, as well as in symptomatic patients with severe degenerative MR who are deemed too high risk for conventional surgical therapy in the opinion of the heart team. In this paper, we discuss the evolution of the MitraClip device, the clinical studies supporting its use as well as the important concept of proportionate and disproportionate MR.

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“…These preliminary results are consistent with the aforementioned 2017 results of the PASCAL system in a compassionate-use setting. 20 Additional studies and longer-term follow-up are needed to validate these initially promising results. To that end, the FDA recently approved CLASP IID/IIF, a prospective, multicenter, randomized, controlled trial that aims to evaluate the safety and effectiveness of the PASCAL system compared with the MitraClip device.…”

Section: Pascalmentioning

confidence: 99%