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Updated: Nov 30, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
MitraClip or Ventricular Assist Device?
Shuhei Tanaka1, Teruhiko Imamura1, Hiroshi Ueno1
1Second Department of Internal Medicine, University of Toyama.
Abstract:
The patient was a 59-year-old female with advanced heart failure and severe functional mitral regurgitation who was classified as INTERMACS profile 4 with repeated hospitalizations despite guideline-directed medical therapy. She was also listed for heart transplantation. After comparing the two major therapeutic strategies: (1) durable left ventricular assist device (LVAD) implantation and (2) percutaneous MitraClip procedure (Abbott Vascular, Abbott Park, IL, USA), we eventually decided to proceed with MitraClip, given her relatively lower B-type natriuretic peptide, lower MAGGIC Heart Failure risk score, and higher predicted survival without LVAD. The post-procedural course was favorable without any comorbidities or worsening of heart failure for 10 months. A diagnostic paradigm to guide which strategy to choose (LVAD or MitraClip) for patients with advanced heart failure and functional mitral regurgitation should be constructed.
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