Esc patient selection for Mitraclip

Proposed criteria for patient selection for transcatheter mitral valve repair . Francesco Maisano MD, FESC (Milan, IT) San Raffaele Hospital Cardio-thoracic and Vascular Department

Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial Interest /arrangement or affiliation with the organization(s) listed below Affiliation/Financial Relationship Company Grant/ Research Support: Consulting Fees/Honoraria: Abbott, Edwards, Nycomed, Medtronic, St Jude, ValtechCardio Major Stock Shareholder/Equity Interest: Royalty Income: Edwards Ownership/Founder: 4Tech Salary: Intellectual Property Rights: ValtechCardio, 4Tech Other Financial Benefit:

Transcatheter Mitral Valve Repair. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient selection – a teamwork effort ,[object Object],[object Object],[object Object],[object Object],Evidence + Risk scores + Guidelines ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?

Mitraclip for DMR ,[object Object],[object Object],[object Object],[object Object]

Mitraclip for FMR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MitraClip anatomical patient selection considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Recommended criteria 1 1. The current patient considerations are based on EVEREST II and commercial European experience to date. The MitraClip Patient Selection Coniderations document has been endorsed by Expert Opinion (Crossroads institute).

Degenerative MR Multiple lesions

Anatomic Measurements P=0.05 P=0.1 San Raffaele Preliminary data

Tenting area and QRS duration p=0.002 P=0.01 San Raffaele Preliminary data

Jet extension (%) Jet extension/IC diameter p=0.01

Rejected for MitraClip ,[object Object]

Surgery vs Mitraclip anatomy for Mitraclip Risk of surgery Low High Bad Good Risk of Mitraclip procedure ,[object Object],[object Object],[object Object]

Concomitant conditions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Individualize the therapy waiting for more actual randomized trials ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Esc patient selection for Mitraclip

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Esc patient selection for Mitraclip