We’ve covered Abbott’s MitraClip extensively on our pages, so thought it was appropriate to provide an update, as reported by theheart.org from this year’s European Society of Cardiologists meeting in Munich. The item can be found here and in a nutshell suggests that real world data on MitraClip comes from older and sicker patient groups than the comparator cohort used in the pivotal EVEREST study, giving a clue as to how the device is being applied. It seems the device is being reserved for extremely sick patients and is not being considered as an alternative to routine surgical valve repair.
The clinical report was made by Dr Wolfgang Schillinger, from University Medical Center Göttingen, Germany and the designated discussant of the study, Dr Simon Ray from the Academic Health Science Centre, Manchester, UK who said: “Clinical practice has evolved beyond the envelope provided by the evidence base of the single randomised trial available.”
He added that: “In expert hands, MitraClip is feasible and has an acceptable procedural risk in patients with comorbidities, but the word ‘expert’ needs to be reiterated,” he commented.
Ray stressed that the procedure should be done only to improve symptoms. “There is no evidence that it improves mortality, and there is no point improving MR grade if there is no symptomatic improvement. And as 25% to 35% of patients derive little or no symptomatic benefit, patient selection is a key issue.”
So there we have it. An ingenious device which may provide symptomatic benefit by reducing mitral valve regurgitation, but not something for everyone and seemingly not an alternative to surgical valve repair.