A heart team’s perspective on interventional mitral valve repair: Percutaneous clip implantation as an important adjunct to a surgical mitral valve program.

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A heart team’s perspective on interventional mitral valve repair: Percutaneous clip implantation as an important adjunct to a surgical mitral valve program for treatment of high-risk patients Hendrik Treede, MD, Johannes Schirmer, MD, Volker Rudolph, MD, Olaf Franzen, MD, Malgorzata Knap, MD, Michael Schluter, PhD, Lenard Conradi, MD, Moritz Seiffert, MD, Dietmar Koschyk, MD, Thomas Meinertz, MD, Stephan Baldus, MD, Hermann Reichenspurner, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 143, Issue 1, Pages 78-84 (January 2012) DOI: 10.1016/j.jtcvs.2011.09.033 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flow-chart on Heart Team decisions in patients with severe MR at the University Heart Center Hamburg. AVR, Aortic valve repair; CABG, coronary artery bypass grafting; LV, left ventricular; MVR, mitral valve repair. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 MR at baseline, postprocedure, and 12 months after interventional MVR using the MitraClip device (Abbott Vascular, Menlo Park, Calif) (P < .0001, chi-square test). MR, Mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Acute reduction in MR from baseline to postprocedure after interventional MVR using the MitraClip device. Mean: −1.7 ± 0.8, n = 202. MR, Mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Change in NYHA functional class from baseline to discharge and during 12 months follow-up after interventional MVR using the MitraClip device (P = .0001, chi-square test). NYHA, New York Heart Association. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Cumulative survival after interventional MVR using the MitraClip device (Kaplan–Meier analysis). The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Clip-related lesions at the anterior and posterior mitral valve leaflets with chordal rupture (arrows). Both valves were repaired successfully. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Volume of surgical and percutaneous mitral valve treatment at the University Heart Center Hamburg 2002–2010. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 78-84DOI: (10.1016/j.jtcvs.2011.09.033) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions