Abstract
In the last decades, the overlapping areas of intervention between
cardiac surgeons and interventional cardiologists are rocketing,
especially in the field of treatment of heart valve disease. But, while
for the aortic valve the competition, even for non-high risk patients,
has become tightened, in the context of mitral regurgitation, the
surgery seems to not have competitors .In fact looking the results of
studies published so far, a question arises: Is surgery the fair
competitor for the Mitraclip? The meta-analysis by Abdul Khader et al
summarized few evidences present in this field, only 11 observational
studies and 1 randomized trial, providing an awesome response: “NO”.
Is therefore not a case if recently two trials, MITRA-FR and COAPT,
chose to use as competitor for MitraClip, more rightly, medical therapy
instead of surgery. In conclusions, in case of mitral regurgitation,
surgery is still largely the gold standard treatment and so MitraClip
cannot be mention at all as competitor of surgery. It can be the right
choice of case of primary MR where patients showed high risk for
surgery. In case of secondary MR, especially with large and poor left
ventricle we should wait for a clear answer on its role, yet.