{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:29:22Z","timestamp":1777890562031,"version":"3.51.4"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We report the 2\u2010year outcomes of the MitrAl ValvE RepaIr Clinical (MAVERIC) trial. Functional mitral regurgitation (FMR) is associated with poor outcomes for which there remains an unmet clinical need. ARTO is a transcatheter annular reduction device for the treatment of FMR and an emerging alternative for patients at high surgical risk. The MAVERIC trial was designed to evaluate the safety and performance of the ARTO system in FMR and heart failure (HF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      MAVERIC is an international multicentre, prospective, single arm study enrolling patients with FMR grade\u2009\u2265\u20092, New York Heart Association (NYHA) class\u2009\u2265II symptoms despite maximal medical therapy. Patients were excluded if they had significant structural mitral valve abnormality or life expectancy &lt;1\u00a0year. The primary outcome measures were a composite safety outcome and efficacy defined as mitral regurgitation (MR) reduction 30\u2009days post\u2010procedure. Secondary outcome measures included safety, change in MR grade, NYHA class and hospitalization for HF at 2\u2009years. Forty\u2010five patients were enrolled. The composite safety outcome was met (2\/45 adverse events at 30\u2009days) and no device\u2010related deaths occurred at 2\u2010year follow\u2010up. A sustained reduction in MR [grade\u2009&lt;\u20092: 21\/31 (68%) vs. 31\/31(0%);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001], left ventricular end\u2010diastolic volume index (90.0\u2009\u00b1\u200930 vs. 106\u2009\u00b1\u200926\u2009mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u00a00.004) and anteroposterior diameter (35.5\u2009\u00b1\u20094.7 vs. 41.4\u2009\u00b1\u20094.6\u2009mm;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001) was seen at 2\u2009years compared to baseline. Progressive symptomatic improvement [NYHA\u2009class \u2264II: 27\/34 (80%) vs. 12\/34 (36%);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001] and a reduction in HF hospitalizations (19.8% 2\u2009years post vs. 52.3% 2\u2009years prior;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) were seen at 2\u2009years compared to baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ARTO system is a safe and effective treatment for FMR with reductions in left ventricular end\u2010diastolic volumes sustained to 2\u2009years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2321","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T01:45:14Z","timestamp":1628300714000},"page":"1775-1783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Two\u2010year outcomes from the\n                    <scp>MitrAl<\/scp>\n                    ValvE Re\n                    <scp>paIr<\/scp>\n                    Clinical (\n                    <scp>MAVERIC<\/scp>\n                    ) trial: a novel percutaneous treatment of functional mitral regurgitation"],"prefix":"10.1093","volume":"23","author":[{"given":"Tiffany","family":"Patterson","sequence":"first","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gregson","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrejs","family":"Erglis","sequence":"additional","affiliation":[{"name":"Pauls Stradins Clinical University Hospital University of Latvia  Riga Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jubin","family":"Joseph","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronak","family":"Rajani","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Wilson","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Prendergast","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Worthley","sequence":"additional","affiliation":[{"name":"GenesisCare  Alexandria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Hildick\u2010Smith","sequence":"additional","affiliation":[{"name":"Sussex Cardiac Centre Brighton &amp; Sussex University Hospitals  Brighton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Rafter","sequence":"additional","affiliation":[{"name":"HeartCare Partners  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Whelan","sequence":"additional","affiliation":[{"name":"HeartCare WA  Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"De Marco","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico San Donato  San Donato Milanese (Milan) Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Horrigan","sequence":"additional","affiliation":[{"name":"Austin Health HeartCare Victoria  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon R.","family":"Redwood","sequence":"additional","affiliation":[{"name":"Cardiovascular Department Kings College London, St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1531"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1491"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab086"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.723"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.04.012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2019.00060"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV11SWA12"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.046"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.601518"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-20-00484"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.12.282"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.849885"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.07.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1616"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2321","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejhf.2321","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:15:02Z","timestamp":1767701702000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejhf.2321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,30]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/ejhf.2321"],"URL":"https:\/\/doi.org\/10.1002\/ejhf.2321","archive":["Portico"],"relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,30]]},"assertion":[{"value":"2021-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}