ABSTRACT
In analyzing EVEREST II, 37 out of the 158 patients or 23.4% crossed over from device to surgery. Of specifi c concern was the possibility that either valve injury or diffi culty in device removal would compromise the ability to perform MV repair and result in MV replacement. In other words, does a MitraClip® procedure “burn a bridge” with regard to a future MV repair if needed? Would there be a signifi cant number of patients eligible for MV repair surgery that would end up with an MVR after a failed MitraClip® procedure? This may not be a major consideration in a high-risk 80-year-old patient; however, it would be a major concern for a healthy 60-year-old patient who might consider MitraClip® instead of conventional mitral repair surgery. Patient and physician acceptance of less invasive coronary stenting over coronary bypass surgery for certain patients, for example, has been enhanced by reassurance that initial stenting does not compromise subsequent coronary surgery if necessary.
