MitraClip bei Herzinsuffizienz: Patientenauswahl und Behandlungserfolg

Abstract

Percutaneous mitral valve repair using the MitraClip procedure is a safe technique in high-risk surgical patients presenting with symptomatic severe mitral valve regurgitation (MR). Especially for MR-patients with advanced heart failure, MitraClip therapy is a valid treatment option. Apart from a considerable improvement of clinical symptoms in these patients, significant structural cardiac “reverse remodeling” and an increase of LVEF is induced by reduction of mitral regurgitation in the course of endovascular mitral valve repair with the MitraClip.

• Literatur

• 1 Enriquez-Sarano M, Akins CW, Vahanian A. Mitral regurgitation. Lancet 2009; 18: 1382-1394
• 2 Rossi A, Dini FL, Faggiano P et al. Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy. Heart 2011; 97: 1675-1680
• 3 Vassileva CM, Boley T, Markwell S et al. Meta-analysis of short-term and long-term survival following repair versus replacement for ischemic mitral regurgitation. Eur J Cardiothorac Surg 2011; 39: 295-303
• 4 Mirabel M, Iung B, Baron G et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?. Eur Heart J 2007; 28: 1358-1365
• 5 Vahanian A, Alfieri O, Andreotti F et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012; 33: 2451-2496
• 6 Bonow RO, Carabello BA, Chatterjee K et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: e1-e142
• 7 Maisano F, La Canna G, Colombo A et al. The evolution from surgery to percutaneous mitral valve interventions: the role of the edge-to-edge technique. J Am Coll Cardiol 2011; 58: 2174-2182
• 8 Smith T, McGinty P, Bommer W et al. Prevalence and echocardiographic features of iatrogenica trial septal defect after catheter-based mitral valve repair with the MitraClip system. Cath Cardiovasc Interv 2012; 80: 678-685
• 9 Feldman T, Foster E, Glower DD et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 2011; 364: 1395-1406
• 10 Feldman T, Kar S, Rinaldi M et al. Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol 2009; 54: 686-694
• 11 Auricchio A, Schillinger W, Meyer S et al. Correction of mitral regurgitation in nonresponders to cardiac resynchronization therapy by MitraClip improves symptoms and promotes reverse remodeling. J Am Coll Cardiol 2011; 58: 2183-2189
• 12 Neuss M, Schau T, Schoepp M et al. Patient selection criteria and midterm clinical outcome for MitraClip therapy in patients with severe mitral regurgitation and severe congestive heart failure. Eur J Heart Fail 2013; 15: 786-795
• 13 Franzen O, Baldus S, Rudolph V et al. Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. Eur Heart J 2010; 31: 1373-1381
• 14 Franzen O, van der Heyden J, Baldus S et al. MitraClip therapy in patients with end-stage systolic heart failure. Eur J Heart Fail 2011; 13: 569-576
• 15 Pleger ST, Mereles D, Schulz-Schönhagen M et al. Acute safety and 30-day outcome after percutaneous edge-to-edge repair of mitral regurgitation in very high-risk patients. Am J Cardiol 2011; 108: 1478-1482
• 16 Pleger ST, Schulz-Schönhagen M, Geis N et al. One year clinical efficacy and reverse cardiac remodelling in patients with severe mitral regurgitation and reduced ejection fraction after MitraClip implantation. Eur J Heart Fail 2013; 15: 919-927
• 17 Geis NA, Pleger ST, Chorianopoulos E et al. Feasibility and clinical benefit of a suture-mediated closure device for femoral vein access after percutaneous edge-to-edge mitral valve repair. EuroIntervention 2013; accepted
• 18 Pleger ST, Chorianopoulos E, Krumsdorf U et al. Percutaneous edge-to-edge repair of mitral regurgitation as a bail-out strategy in critically ill patients. J Invasive Cardiol 2013; 25: 69-72
• 19 A Randomized Study of the MitraClip Device in Heart Failure Patients Woth Clinically Significant Functional Mitral Regurgitation (RESHAPE HF). ClinicalTrials.gov Identifier: NCT01772108Ref