Ricerc@Sapienza

The management of patients with heart disease is rapidly evolving, with advances in diagnostic imaging and improvements in catheter-based interventions. Interventional treatment for moderate-to-severe mitral regurgitation (MR) with MitraClip system is an effective option for symptomatic patients with high operative risk. Although the EVEREST trials enrolled primarily patients with primary or degenerative MR, in current clinical practice, the majority of patients selected for MitraClip therapy have functional or secondary MR. Aim of the present research project is to describe immediate and late changes in annulus geometry after MitraClip implantation identifying anatomical and periprocedural factors that may have an impact on procedural success in patients with secondary MR. We wanted to investigate the impact of anulus remodeling on early and late procedural success dividing our patients population according a significant MR reduction after MitraClip implant. RT3D-TEE has become the standard imaging technique for procedural guidance of MitraClip implantation. We intended to use echocardiographic data recorded before, during and immediately after the intervention, to obtain more insights into the acute and late effects of MitraClip therapy on the mitral valve apparatus. All 3D-TEE data will be analyzed with Mitral Valve Navigator, QLAB 10.0 software by Philips, to obtain a reliable geometrical reconstruction of the mitral valve with accurate measurements. Patients will have a clinical and echocardiographic follow-up at 6 months. From the results of this study we expected to individuate additional criteria predicting procedural success, able to improve a correct patient' selection.