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For Failed MitraClip, Next Procedure Might Depend on MR Etiology

Photo Credit: Hannes Alessandrini) As MitraClip procedures continue to expand as an option for nonsurgical patients with functional or degenerative mitral regurgitation (MR), a new question will increasingly arise: what’s the best approach for treating patients whose clip procedures fail? Now, a small, retrospective, single-center study is trying to shed some light. As Hannes Alessandrini, MD (Asklepios Klinik St. Georg, Hamburg, Germany), and colleagues write in EuroIntervention this month, the best approach may depend on the source of mitral valve dysfunction in the first place. “There are two conclusions that we have reached,” Alessandrini told TCTMD. “The first is that we have less concern about considering a surgical intervention after transcatheter mitral valve repair in patients with primary mitral regurgitation. . . . And the second is that we also have less concern about performing a second intervention with the edge-to-edge therapy in patients where we have see

People Age 90-Plus Do Fine With EVAR

April 13, 2021 Abdominal aortic aneurysm (AAA) patients who are 90 or older fare just as well as their younger counterparts after endovascular aneurysm repair (EVAR), a study shows. After accounting for differences in comorbidity burden and other factors with propensity-score matching, 30-day mortality and major adverse event rates did not significantly differ between nonagenarians and patients from other age groups, lead author Carlota Fernandez Prendes, MD (Ludwig-Maximilians-University Hospital, Munich, Germany), and colleagues report. The findings, published in the April 20, 2021, issue of the Journal of the American College of Cardiology, were consistent in patients with either intact or ruptured aneurysms. “Just using age as a [criterion] for intact and for ruptured aneurysms should not exclude patients from receiving treatment” with EVAR, Prendes told TCTMD. Instead, she and her co-authors recommend “tailored indications and carefully balanced risk assessment” to

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