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Ann Thorac Surg 2005;80:2338-2342
© 2005 The Society of Thoracic Surgeons
a Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York
b Division of Cardiology, Columbia University, College of Physicians and Surgeons, New York, New York
c The Cleveland Clinic Foundation, Cleveland, Ohio
d Department of Cardiothoracic Surgery, Evanston Northwestern Healthcare, Evanston, Illinois
e Department of Cardiology, Evanston Northwestern Healthcare, Evanston, Illinois
f Department of Cardiology, Emory Healthcare, Atlanta, Georgia
Accepted for publication May 11, 2005.
* Address correspondence to Dr Oz, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University, College of Physicians and Surgeons, 177 Fort Washington Ave, Milstein Hospital Building 7GN-435, New York, NY10032 (Email: mco2{at}columbia.edu).
PURPOSE: Almost 50,000 mitral valve operations are performed annually in the United States, with an increasing number of repairs. Recently, a percutaneous mitral valve repair option that achieves edge-to-edge approximation with a clip has been described in patients with mitral regurgitation.
DESCRIPTION: We describe 6 patients from three centers with mitral regurgitation after percutaneous repair who underwent reintervention. During open surgical revision, the clips were uneventfully removed in all patients with no limitation in surgical options. Five patients underwent repair and 1 underwent replacement.
EVALUATION: After surgical revision, mitral regurgitation was significantly decreased, and all but 1 patient underwent uneventful recovery. One patient developed ilio-femoral deep venous thrombosis that was treated successfully with anticoagulation.
CONCLUSIONS: Preserving standard of care options is critical with any evolving technology in the event of initial treatment failure. Standard surgical options were preserved in all of the patients who underwent percutaneous mitral valve edge-to-edge repair. Furthermore, a thorough understanding of the clip design, in particular its unlocking mechanism, is essential and facilitates surgical clip removal.
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