{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:36:44Z","timestamp":1784173004757,"version":"3.55.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,4,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>The safety and effectiveness of the MitraClip device (Abbott Vascular, Menlo Park, CA) is being evaluated in the Endovascular Valve Edge-to-Edge Repair Study (EVEREST) clinical studies. The healing response after device implantation has not previously been characterized in humans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      A total of 67 explanted devices (implantation duration, 1 to 1878 days) from 50 patients were submitted for histological evaluation. Explants were analyzed in 4 implantation intervals: acute (\u226430 days; n=7), subacute (31 to 90 days; n=23), chronic (91 to 300 days; n=18), and long term (&gt;300 days; n=19). The acute healing response consisted of platelet\/fibrin deposition. The subacute response exhibited granulation tissue with early fibrous encapsulation (pannus). The chronic response was characterized by various degrees of tissue bridging between the device arms. The long-term healing response demonstrated collagen-rich matrix (by type I collagen), incorporating the device components with complete encapsulation by organized, fibrous growth. In long-term devices with minimal surgical disruption, a fibrous tissue bridge (mean area, 7.39\u00b14.3 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) was observed over and between the device arms, resulting in atrial tissue continuity between the 2 valve leaflets. Devices demonstrated no evidence of endocarditis, mechanical wear, component fracture, or corrosion up to the time of explantation (median, 119 days; first and third quartiles, 42 and 365 days).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In all patients, device mechanical integrity was maintained up to the time of explantation. Four phases of physiological healing were observed: platelet and fibrin deposition, inflammation, granulation tissue, and finally, fibrous encapsulation. Long-term device fibrous encapsulation with extension over adjacent mitral leaflets and tissue bridge formation adds structural stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\/show\/NCT00209274\">http:\/\/clinicaltrials.gov\/show\/NCT00209274<\/jats:ext-link>\n                      . Unique identifiers: NCT00209339 and NCT00209274.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.110.978130","type":"journal-article","created":{"date-parts":[[2011,3,22]],"date-time":"2011-03-22T01:45:14Z","timestamp":1300758314000},"page":"1418-1427","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":87,"title":["Pathological Healing Response of Explanted MitraClip Devices"],"prefix":"10.1161","volume":"123","author":[{"given":"Elena","family":"Ladich","sequence":"first","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth","family":"Michaels","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell M.","family":"Jones","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"McDermott","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Coleman","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Komtebedde","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Glower","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Argenziano","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted","family":"Feldman","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Nakano","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Virmani","sequence":"additional","affiliation":[{"name":"From the CVPath Institute, Inc., Gaithersburg, MD (E.L., R.M.J., M.N., R.V.); Abbott Vascular, Abbott Park, IL (M.B.M., E.M., L.C., J.K.); Duke University Medical Center, Durham, NC (D.G.); Columbia University, New York, NY (M.A.); and Evanston Hospital, Evanston, IL (T.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.117277"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.065"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.06.066"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.03.077"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2008.07.001"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)01391-4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60692-9"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct0806111"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00041433-199912000-00004"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2005.08.010"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.020271"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20917"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2009.00901.x"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199608083350607"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq050"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.110.978130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:50:55Z","timestamp":1715565055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.110.978130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,4,5]]},"references-count":16,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2011,4,5]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.110.978130"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.110.978130","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.717047801.792352803","asserted-by":"object"}]},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,4,5]]},"assertion":[{"value":"2010-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-02-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}