{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:28:14Z","timestamp":1780093694806,"version":"3.54.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1564,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Percutaneous mitral valve repair (PMVR) via MitraClip implantation is a therapeutic option for severe mitral regurgitation (MR) in advanced stages of heart failure (HF). However, progressive left ventricular dilation in these patients may lead to recurrent MR after PMVR and consequent re-do MitraClip implantation. Here, we describe the characteristics and outcomes of this clinical scenario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with systolic HF and functional MR undergoing a re-do MitraClip procedure were retrospectively analysed. Inclusion criteria were age \u226518 years, technical, device and procedural success at first MitraClip procedure, functional MR and systolic HF with an ejection fraction (EF) of &amp;lt;45%. Seventeen out of 684 patients undergoing PMVR with the MitraClip device at our institution between September 2009 and July 2019 were included. All patients displayed advanced HF with an EF of 20% (\u00b19.9) and highly elevated N-terminal pro-brain natriuretic peptide. Technical success of the re-do MitraClip procedure was 100%, whereas procedural and device success were only achieved in 11 patients (65%). Unsuccessful re-do procedures were related to lower EF and implantation of more than one clip at initial procedure. However, despite reduction in MR grade and no occurrence of significant mitral stenosis after the procedure, the mortality during 12 months follow-up remained high (8 of 17; 47%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a cohort of patients with advanced HF undergoing PMVR, re-do MitraClip procedure was feasible, but procedural success was unsatisfactory and morbidity and mortality remained high, possibly reflecting the advanced stage of HF in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13564","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T23:42:35Z","timestamp":1631144555000},"page":"4617-4625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Re-Do MitraClip in Patients with Functional Mitral Valve Regurgitation and Advanced Heart Failure"],"prefix":"10.1093","volume":"8","author":[{"given":"Michael M.","family":"Kreusser","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas A.","family":"Geis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Grossekettler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Volz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Hamed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo A.","family":"Katus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven T.","family":"Pleger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip W.","family":"Raake","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Cardiology, University of Heidelberg , Im Neuenheimer Feld 410, Heidelberg, 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"2026012114200253000_ehf213564-bib-0001","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the 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