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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

133
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
133
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

138
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
138
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

187
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
187
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

190
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
190
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

180
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
180
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

185
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
185

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Updated: Nov 29, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Mitral valve surgery after a failed MitraClip procedure.

Francesco Melillo1, Luca Baldetti1, Alessandro Beneduce1

  • 1Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy.

Interactive Cardiovascular and Thoracic Surgery
|November 22, 2020
PubMed
Summary
This summary is machine-generated.

Mitral valve surgery after a failed MitraClip procedure has high mortality rates. Most patients require valve replacement due to leaflet injury, highlighting the risks of this intervention.

Keywords:
FailureMitral regurgitationPercutaneous edge-to-edgeSurgeryTranscatheter mitral valve repair

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter mitral valve repair using the MitraClip device is an alternative to surgery.
  • A significant percentage of patients require open mitral valve surgery within one year due to failed MitraClip implantation.

Purpose of the Study:

  • To review outcomes of mitral valve surgery following MitraClip procedures.
  • To estimate in-hospital and follow-up mortality rates in these patients.

Main Methods:

  • A meta-analysis of published clinical studies on surgical intervention for failed MitraClip procedures.
  • Inclusion of 20 reports with 172 patients.
  • Calculation of pooled estimates and confidence intervals using a random-effects model.

Main Results:

  • The average patient age was 70.5 years, with most having functional or degenerative mitral regurgitation.
  • Indications for surgery included persistent mitral regurgitation (93%) and mitral stenosis (6%).
  • In-hospital mortality was 15%, with 6% experiencing cerebrovascular accidents. All-cause death at 12 months was 26.5%.

Conclusions:

  • Surgical intervention after failed transcatheter mitral valve repair is associated with high mortality.
  • High-risk patient profiles contribute to adverse outcomes.
  • Mitral valve replacement is frequently necessary due to valve injury from the clip.