Patient selection for MitraClip therapy impaired left ventricular systolic function.

摘要: Mitral regurgitation (MR) is a disabling disease associated with poor prognosis and high incidence of clinical events if left untreated. To reduce the invasiveness surgical approach, different types transcatheter procedures are becoming available. The MitraClip procedure (Abbott Vascular Inc. Menlo Park, CA, USA) yet only catheter-based available in practice at moment. device has been evaluated number preclinical studies, registries FDA approved trials. (EVEREST trial, ACCESS-EU trial). Indication timing intervention crucial step diagnostic-therapeutic pathway patients mitral regurgitation. aim this review to clarify potential practice, particularly focusing on patient selection for novel therapy. Patient overall decision making strongly influenced by anatomical factors. Decision-making degenerative MR (DMR) vs. functional (FMR) can be quite different. Generally, effective treating either type II or IIIb dysfunction (at moment FMR main indication Europe, according ACCESS registry data). relative role surgery management still unclear. From global initial experience, therapy could complementary those risk who have ideal characteristics implantation. predictable favorable anatomy. In suboptimal anatomy, too high, indicated sometimes. Our preliminary experience suggests that DMR, EVEREST criteria strong predictors early mid-term success. According it, appropriate DMR anatomy clip implantation criteria. refractory medical resynchronization therapy, considered as first option comorbidities, advanced age, being operative above 5% population. future, devices, improved knowledge, more efficient imaging prosthetic valve may expand indications currently not treated unsuitability, improve results both term efficacy long durability.