eprintid: 26342 rev_number: 13 eprint_status: archive userid: 1589 dir: disk0/00/02/63/42 datestamp: 2019-06-17 10:43:06 lastmod: 2019-07-11 11:47:23 status_changed: 2019-06-17 10:43:06 type: article metadata_visibility: show creators_name: Mkalaluh, Sabreen creators_name: Szczechowicz, Marcin creators_name: Karck, Matthias creators_name: Weymann, Alexander title: Failed MitraClip therapy: surgical revision in high-risk patients subjects: 610 divisions: 910100 keywords: MitraClip therapy, Mitral regurgitation, Surgical therapy, Outcome, Short-term survival abstract: Background: MitraClip implantation is a valid interventional option that offers acceptable short-term results. Surgery after failed MitraClip procedures remains challenging in high-risk patients. The data on these cases are limited by the small sample numbers. Aim: The aim of our study is to show, that mitral valve surgery could be possible and more advantageous, even in high-risk patients. Methods: Between 2010 and 2016, nine patients underwent mitral valve surgery after failed MitraClip therapy at our institution. Results: The patients’ ages ranged from 19 to 75 years (mean: 61.2 ± 19.6 years). The median interval between the MitraClip intervention and surgical revision was 45 days (range: 0 to 1087 days). In eight of nine patients, the MitraClip intervention was initially successful and the mitral regurgitation was reduced. Only one patient had undergone cardiac surgery previously. Intra-operatively, leaflet perforation or rupture, MitraClip detachment, and chordal or papillary muscle rupture were potentially the causes of recurrent mitral regurgitation. There were three early deaths. One year after surgery, the six remaining patients were alive. Conclusions: Mitral valve surgery can be successfully performed after failed MitraClip therapy in high-risk patients. The initial indication for MitraClip therapy should be considered carefully for possible surgical repair. date: 2019 publisher: BioMed Central id_scheme: DOI ppn_swb: 1667650467 own_urn: urn:nbn:de:bsz:16-heidok-263422 language: eng bibsort: MKALALUHSAFAILEDMITR2019 full_text_status: public publication: Journal of Cardiothoracic Surgery volume: 14 number: 75 place_of_pub: London pagerange: 1-4 issn: 1749-8090 citation: Mkalaluh, Sabreen ; Szczechowicz, Marcin ; Karck, Matthias ; Weymann, Alexander (2019) Failed MitraClip therapy: surgical revision in high-risk patients. Journal of Cardiothoracic Surgery, 14 (75). pp. 1-4. ISSN 1749-8090 document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26342/1/13019_2019_Article_891.pdf