ABSTRACT
Edge-to-edge mitral valve repair aims to improve mitral leafl et coaptation and to reduce or eliminate signifi cant mitral regurgitation (MR) by approximating the middle scallops of the mitral valve, thus creating a double orifi ce for diastolic infl ow (1-6). The surgical edge-to-edge repair technique is approximated by the percutaneous transcatheter MitraClip® system, in which a clip is placed on the mitral valve via a steerable transseptal system (7-11). The MitraClip® is a polyester fabriccovered cobalt-chromium implantable clip with two arms which can be opened and closed with a steerable-guiding mechanism. A larger steerable guide catheter with a steerable clip delivery catheter is used, allowing for precise placement of the clip in the desired location on the mitral valve. The device has been shown to be effective in selected patients with either degenerative (both prolapsed leafl ets and fl ail leafl ets) or functional MR due to ischemic or dilated cardiomyopathy (9,12-14). The MitraClip® has been used most extensively to successfully treat mitral regurgitation arising from the central aspect of the mitral valve, at the A2 and P2 scallops. Alternative uses, such as commissural clip placement, have been reported as well, but the greatest experience is with the creation of a double-orifi ce mitral valve with approximation of A2-P2.
