{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:24:44Z","timestamp":1791361484326,"version":"4.3.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Among patients undergoing transcatheter mitral valve repair with the MitraClip device, a relevant proportion (2\u20136%) requires open mitral valve surgery within 1\u2009year after unsuccessful clip implantation. The goal of this review is to pool data from different reports to provide a comprehensive overview of mitral valve surgery outcomes after the MitraClip procedure and estimate in-hospital and follow-up mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All published clinical studies reporting on surgical intervention for a failed MitraClip procedure were evaluated for inclusion in this meta-analysis. The primary study outcome was in-hospital mortality. Secondary outcomes were in-hospital adverse events and follow-up mortality. Pooled estimate rates and 95% confidence intervals (CIs) of study outcomes were calculated using a DerSimionian\u2013Laird binary random-effects model. To assess heterogeneity across studies, we used the Cochrane Q statistic to compute I2 values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Overall, 20 reports were included, comprising 172 patients. Mean age was 70.5\u2009years (95% CI 67.2\u201373.7\u2009years). The underlying mitral valve disease was functional mitral regurgitation in 50% and degenerative mitral regurgitation in 49% of cases. The indication for surgery was persistent or recurrent mitral regurgitation (grade &amp;gt;2) in 93% of patients, whereas 6% of patients presented with mitral stenosis. At the time of the operation, 80% of patients presented in New York Heart Association functional class III\u2013IV. Despite favourable intraoperative results, in-hospital mortality was 15%. The rate of periprocedural cerebrovascular accidents was 6%. At a mean follow-up of 12\u2009months, all-cause death was 26.5%. Mitral valve replacement was most commonly required because the possibility of valve repair was jeopardized, likely due to severe valve injury after clip implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgical intervention after failed transcatheter mitral valve intervention is burdened by high in-hospital and 1-year mortality, which reflects reflecting the high-risk baseline profile of the patients. Mitral valve replacement is usually required due to leaflet injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaa270","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T11:17:44Z","timestamp":1603279064000},"page":"380-385","source":"Crossref","is-referenced-by-count":26,"title":["Mitral valve surgery after a failed MitraClip procedure"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2159-1359","authenticated-orcid":false,"given":"Francesco","family":"Melillo","sequence":"first","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5986-049X","authenticated-orcid":false,"given":"Luca","family":"Baldetti","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2130-1964","authenticated-orcid":false,"given":"Alessandro","family":"Beneduce","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eustachio","family":"Agricola","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"},{"name":"Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Margonato","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"},{"name":"Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmo","family":"Godino","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"2022030919183324600_ivaa270-B1","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1093\/eurheartj\/ehv627","article-title":"One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry","volume":"37","author":"Puls","year":"2016","journal-title":"Eur Heart J"},{"key":"2022030919183324600_ivaa270-B2","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1016\/j.jacc.2017.09.015","article-title":"Outcomes with transcatheter mitral valve repair in the United States: an STS\/ACC TVT registry 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