Related Experiment Video
Updated: Oct 2, 2025
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
4.0K
Clinical Outcomes after Mitral Valve Surgery in Failed MitraClip Procedures
Clarence Pingpoh1,2, Maximillian Kreibich1,2, Tim Berger1,2
1Department of Cardiovascular Surgery, University Heart Center Freiburg, Bad Krozingen, Germany.
The Thoracic and Cardiovascular Surgeon
|February 25, 2022
Summary
Mitral valve replacement (MVR) after a failed MitraClip procedure is uncommon but yields acceptable outcomes. Underlying pathology, not just risk factors, should guide initial treatment decisions for mitral valve repair or replacement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- MitraClip procedures offer a less invasive option for mitral regurgitation.
- Failure of MitraClip necessitates further intervention, often mitral valve replacement (MVR).
- Understanding outcomes after MVR following MitraClip is crucial for patient management.
Purpose of the Study:
- To evaluate the in-hospital and overall outcomes of patients undergoing mitral valve replacement (MVR) after a failed MitraClip procedure.
- To identify reasons for MVR post-MitraClip and patient characteristics.
Main Methods:
- Retrospective analysis of 26 patients who underwent MVR after MitraClip between June 2010 and December 2020.
- Assessment of in-hospital and overall mortality during a median follow-up of 72 days post-MVR.
Main Results:
- In-hospital mortality was 15.4% and overall mortality was 27%.
- Common indications for MVR included mitral stenosis, leaflet prolapse, and tethering.
- Most patients had advanced heart failure (NYHA class 3+) and secondary mitral valve pathology.
Conclusions:
- Mitral valve replacement after MitraClip failure is infrequently required but associated with acceptable results.
- Decision-making for initial treatment should prioritize underlying pathology over concomitant risk factors.
- Limited reconstructive options often make MVR the necessary next step after MitraClip failure.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
34
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...
34
01:25Mitral Regurgitation III: Medical Management
44
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...
44
01:22Mitral Valve Prolapse II: Assessment and Management
54
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...
54
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
42
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
42
01:28Mitral Regurgitation IV: Nursing Management
113
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
113
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
69
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
69