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Is surgery the fair competitor for MitraClip?
  • +3
  • Michele Di Mauro,
  • Eleana Raviola,
  • Stefano Guarracini,
  • Massimo Di Marco,
  • Roberto Lorusso,
  • Antonio Calafiore
Michele Di Mauro
Maastricht UMC+
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Eleana Raviola
Maria Cecilia Hospital SpA
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Stefano Guarracini
Pierangeli Hospital
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Massimo Di Marco
Santo Spirito Hospital
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Roberto Lorusso
Maastricht University Medical Centre
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Antonio Calafiore
Gemelli Molise
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Abstract

In the last decades, the overlapping areas of intervention between cardiac surgeons and interventional cardiologists are rocketing, especially in the field of treatment of heart valve disease. But, while for the aortic valve the competition, even for non-high risk patients, has become tightened, in the context of mitral regurgitation, the surgery seems to not have competitors .In fact looking the results of studies published so far, a question arises: Is surgery the fair competitor for the Mitraclip? The meta-analysis by Abdul Khader et al summarized few evidences present in this field, only 11 observational studies and 1 randomized trial, providing an awesome response: “NO”. Is therefore not a case if recently two trials, MITRA-FR and COAPT, chose to use as competitor for MitraClip, more rightly, medical therapy instead of surgery. In conclusions, in case of mitral regurgitation, surgery is still largely the gold standard treatment and so MitraClip cannot be mention at all as competitor of surgery. It can be the right choice of case of primary MR where patients showed high risk for surgery. In case of secondary MR, especially with large and poor left ventricle we should wait for a clear answer on its role, yet.

Peer review status:ACCEPTED

13 Dec 2020Submitted to Journal of Cardiac Surgery
14 Dec 2020Assigned to Editor
14 Dec 2020Submission Checks Completed
14 Dec 2020Review(s) Completed, Editorial Evaluation Pending
14 Dec 2020Editorial Decision: Accept