[The MitraClip procedure]

Abstract

Mitral insufficiency is a frequently occurring valvular disease for which surgery is the reference treatment. A large number of patients are at high risk or even contraindicated for surgery due to comorbidities. The MitraClip procedure reproduces a surgical technique for mitral valve repair. Global experience includes over 12,000 patients and has been mainly reported in registries with limited follow-up. The degree of reduction of mitral insufficiency is less with the MitraClip than with surgery. Safety of the procedure is good in experienced centres. Most patients have functional improvement in the mid-term. The procedure may be considered in patients who are at high risk for surgery and remain symptomatic despite optimal medical treatment. In the future, more data are needed from longer follow-up and randomised trials. Both the technique and the equipment used in the procedure need to improve. In addition, it is hoped that combined percutaneous procedures will be available in the near future.