Concept of the central clip: When to use one or two MitraClips®

Eduardo Alegria-Barrero, Pak Hei Chan, Nicolas Foin, Dimitrios Syrseloudis, Guido Tavazzi, Susanna Price, Alistair C. Lindsay, Alison Duncan, Neil Moat, Carlo Di Mario, Olaf W. Franzen

Research output: Contribution to journalArticle


Aims: Percutaneous edge-to-edge mitral valve repair with the MitraClip® was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. We analyse the concept of the central clip and the predictors for the need of more than one MitraClip® in our high-risk surgical population with severe mitral regurgitation (MR). Methods and results: Patients with severe MR (3 or 4+) and high operative risk (as defined by logistic EuroSCORE) refused for conventional mitral valve repair were considered for MitraClip®. The procedure was performed under general anaesthesia with transoesophageal echocardiographic (TOE) guidance. Device success was defined as placement of one or more MitraClips® with a reduction of MR to ≤2+. Patients were followed up clinically and with TOE at one month and one year. From September 2009 to March 2012, 43 patients with severe MR with a mean age of 74.8±10.7 years (30 males, 13 females; mean logistic EuroSCORE 24.1±11, mean LVEF 47.5±18.5%; mean±SD) were treated. Median follow-up was 385 days (104-630; Q1-Q3). Device implantation success was 93%. All patients were treated following the central clip concept: 52.5% of MR was degenerative in aetiology and 47.5% was functional. The degree of MR was reduced from 3.6±0.4 to 1.4±0.6 (p

Original languageEnglish
Pages (from-to)1217-1224
Number of pages8
Issue number10
Publication statusPublished - Feb 2014



  • Heart failure
  • Mitral regurgitation
  • Percutaneous mitral valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Alegria-Barrero, E., Chan, P. H., Foin, N., Syrseloudis, D., Tavazzi, G., Price, S., Lindsay, A. C., Duncan, A., Moat, N., Di Mario, C., & Franzen, O. W. (2014). Concept of the central clip: When to use one or two MitraClips®. EuroIntervention, 9(10), 1217-1224.