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Rodinò et al. Mini-invasive Surg 2020;4:70 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.55

Review Open Access

Percutaneous “edge-to-edge” leaflet repair in
patient with primary mitral valve regurgitation

Giulio Rodinò, Giulia Masiero, Giuseppe Tarantini

Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padova, Padova 35128, Italy.
Correspondence to: Dr. Giuseppe Tarantini, Department of Cardiac, Thoracic and Vascular Science, University of Padova, Via
Giustiniani 2, Padova 35128, Italy. E-mail: giuseppe.tarantini.1@gmail.com

How to cite this article: Rodinò G, Masiero G, Tarantini G. Percutaneous “edge-to-edge” leaflet repair in patient with primary
mitral valve regurgitation. Mini-invasive Surg 2020;4:70. http://dx.doi.org/10.20517/2574-1225.2020.55

Received: 8 Jun 2020 First Decision: 27 Jul 2020 Revised: 7 Aug 2020 Accepted: 19 Aug 2020 Published: 16 Oct 2020

Academic Editor: Azeem Latib Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Mitral regurgitation (MR) is the most common left-sided heart valve disease in developed countries with a
constantly rising number of patients requiring hospitalization or intervention. Organic MR is defined as a primary
structural abnormality of the mitral valve (MV) apparatus which may be caused by a broad set of pathological
processes, among which myxomatous degeneration of the leaflets causing MV prolapse is the most common.
If left untreated, chronic severe MR leads to serious adverse outcomes, from heart failure to death, but medical
therapy is unable to change the natural history of the disease. Surgical correction, by means of valve repair or
replacement, is the gold standard for the treatment of symptomatic patients with severe primary MR. However,
surgery is not feasible for a large percentage of patients because of old age, reduced left ventricular ejection
fraction and the presence of severe comorbidities. Therefore, in recent years, several percutaneous therapeutic
alternatives suitable for high or prohibitive surgical risk patients were developed. In this review we discuss
the transcatheter treatment of primary MR, from available evidence to technical practice, with a focus on the
percutaneous “edge-to-edge” leaflet repair performed with the MitraClip System and the PASCAL Repair System.

Keywords: Degenerative mitral valve disease, mitral regurgitation, mitral insufficiency, MitraClip, PASCAL

INTRODUCTION
Mitral regurgitation (MR) is the most common left-sided heart valve disease in developed countries with
a prevalence that increases with age (from 0.5% among subjects 18-44 years old to 9.3% in the population

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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