INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

PERCUTANEOUS EDGE-TO-EDGE MITRAL VALVE REPAIR USING THE MITRACLIP AND PASCAL SYSTEM

Ozan Tezen

Oltu State Hospital, Department of Cardiology, Erzurum, Türkiye

Tezen O. Percutaneous Edge-toEdge Mitral Valve Repair Using the Mitraclip and Pascal System. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.115-126.

ABSTRACT

Mitral regurgitation (MR) is a common cardiovascular disease associated with high morbidity and mortality, with surgical repair or replacement being the standard treatment approach. However, minimally invasive alternatives are increasingly gaining importance for high-risk surgical candidates. Percutaneous edge-to-edge mitral valve repair using the MitraClip device has emerged as a safe and effective option for patients who are ineligible for surgery or at high surgical risk. Large-scale studies, including EVEREST, COAPT, and MITRA-FR, have assessed the clinical efficacy of MitraClip, demonstrating reduced mortality and hospitalization rates, particularly in patients with secondary MR who remain symptomatic despite optimal medical therapy.

However, patient selection, anatomical suitability, and post-procedural management remain critical determinants of MitraClip’s success. Although the procedure has a favorable perioperative risk profile, complications such as partial clip detachment, transseptal complications, and the need for reintervention must be considered. Further research is required to establish long-term efficacy and refine optimal patient selection criteria. Future studies should focus on improving patient selection strategies, optimizing procedural techniques, and evaluating long-term survival and quality-of-life outcomes. As its clinical application continues to expand, MitraClip is expected to play an increasingly significant role in the management of mitral regurgitation, providing a crucial alternative for patients deemed unsuitable for surgery.

Keywords: Mitral regurgitation; MitraClip; Percutaneous mitral valve repair; Transcatheter edge-to-edge repair (TEER); Secondary mitral regurgitation

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