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KMID : 1146320160040010014
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Journal of Health Technology Assessment
2016 Volume.4 No. 1 p.14 ~ p.22
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MitraClip for Mitral Regurgitation in Patients at High Surgical Risk: Review on Safety and Effectiveness
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Chun Sae-Im
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Abstract
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Objectives: Mitral regurgitation (MR) is a valvular disorder common in aged society. Treatment option available to patients with moderate to severe MR is surgical management, in the form of mitral valve repair or replacement. However, patients with MR often have both cardiac and non-cardiac comorbidities. Transcatheter mitral valve repair (TMVR) using MitraClip is introduced for these patients. The aim of this study is to review recent evidence of TMVR using the leaflet repair device.
Methods: From August 2015 to March 2016, literature search was conducted with terms: MR, mitral valve surgery, MitraClip, percutaneous mitral valve repair, TMVR. Of total 422 publications, 26 publications including 2 systematic reviews were finally selected for detailed review.
Results: Reported outcome for 30-day mortality was ranged from 0 to 8.0%, 1-year mortality range was 11.5 to 23.6%. 4-year outcome was reported with survival, 76.1%. Incidence rate of complications ranged from 12.6 to 22%. Effectiveness outcome was measured with New York Heart Association class and MR level improvement, of which all studies reported improvement post-procedure. Compared to mitral valve surgery, mortality and complications were lower for TMVR, and heart function improvement was similar in both treatment in indirect comparison reviewed in systematic reviews.
Conclusion: Clinical evidence of transcather mitral valve repair using MitraClip shows safe and effective outcome for patients with moderate to severe MR. The novel procedure can provide treatment option for patients at high surgical risk.
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KEYWORD
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Transcatheter mitral valve repair, percutaneous mitral valve repair, MitraClip, mitral regurgitation, systematic review
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