To Clip or Not to Clip: The Use of MitraClip Therapy for Functional Mitral Regurgitation.

Percutaneous edge-to-edge repair of the mitral valve with the MitraClip device has been shown to serve as a safe and effective treatment for severe mitral regurgitation in the high-risk surgical population. Although the device originally was designed for the reduction of degenerative mitral regurgitation resulting from primary leaflet abnormalities, numerous studies have included patients with functional mitral regurgitation from annular or ventricular distortion. Two recent landmark studies examined the use of the MitraClip device for functional mitral regurgitation treatment and found drastically opposing results. Data reconciliation by others has suggested only a subset of those with functional mitral regurgitation may benefit from this treatment. Herein 2 seemingly similar cases to illustrate the subtle differences in patient selection that eventually may change the clinical outcome for this procedure are presented.