{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:06:38Z","timestamp":1791216398782,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T00:00:00Z","timestamp":1461283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the feasibility, safety, and efficacy of Mitraclip therapy in patients with functional mitral regurgitation (MR) and missing leaflet coaptation (MLC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Out of 62 consecutive patients with functional MR undergoing Mitraclip implantation, 22 had MLC defined as the presence of a \u2018gap\u2019 between two mitral leaflets or insufficient coaptation length (&amp;lt;2 mm), according to the EVEREST II criterion. Compared with the control group, the MLC population had a significantly higher effective regurgitant orifice area (0.67 \u00b1 0.31 vs. 0.41 \u00b1 0.13 cm2; P = 0.019) and sphericity index (0.80 \u00b1 0.11 vs. 0.71 \u00b1 0.10; P = 0.003). MLC patients were treated with pharmacological\/mechanical support in order to improve leaflet coaptation and to prepare the mitral valve apparatus for grasping. Implantation of &amp;gt;1 clip and device time were comparable in patients with and without MLC (61.9% vs. 47.5%; P = 0.284 and 101 \u00b1 39 vs. 108 \u00b1 69 min; P = 0.646, respectively). No significant differences were observed between the two cohorts in technical success (95.5% vs. 97.5%, P = 0.667), 30-day device success (85.7% vs. 78.9%; P = 0.525), procedural success (81.8% vs. 75%; P = 0.842), and 1-year patient success (52.9% vs. 44.1%; P = 0.261), defined according to the MVARC (Mitral Valve Academic Research Consortium) criteria. The long-term composite endpoint of cardiovascular death and heart failure hospitalization was similar in the two groups (49.9% vs. 44.4%; P = 0.348). A significant improvement of MR and NYHA functional class and a lack of reverse remodelling were observed up to 2 years in both arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Mitraclip procedure could be extended to patients with functional MR who do not fulfil the coaptation length EVEREST II criterion and who would otherwise be excluded from this treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.520","type":"journal-article","created":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T17:14:18Z","timestamp":1461345258000},"page":"1278-1286","source":"Crossref","is-referenced-by-count":18,"title":["Mitraclip Therapy in Patients with Functional Mitral Regurgitation and Missing Leaflet Coaptation: Is it Still an Exclusion Criterion?"],"prefix":"10.1093","volume":"18","author":[{"given":"Marianna","family":"Adamo","sequence":"first","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermanna","family":"Chiari","sequence":"additional","affiliation":[{"name":"Echocardiographic Laboratory, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Curello","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Maiandi","sequence":"additional","affiliation":[{"name":"Echocardiographic Laboratory, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliano","family":"Chizzola","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Fiorina","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Frontini","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Anaesthesiology, Cardiothoracic Department, Spedali Civili, Brescia \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cuminetti","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Pezzotti","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Rovetta","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Cardiothoracic Department, Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Mario","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiology, Cardiothoracic Department; Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Manzato","sequence":"additional","affiliation":[{"name":"Division of 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