Mitral Clip Screening

ECHONOMY
Tools for Echocardiographic Calculations
Muhamed Saric, MD, PhD
New York University

Exclusion Criteria

Below are the basic anatomic exclusion criteria for mitral valve clipping in addition to the following:

	A2 or P2 calcification in the grasping area or the presence of any significant cleft
	Primary regurgitant jet NOT originating from malcoaptation of the A2 and P2
	Severe mitral annular calcifications
	Mitral stenosis (mitral valve area < 4.0 cm²)
	LV end-systolic diameter > 5.5 cm
	LVEF < 25%
	Presence of ASD (whether repaired or not) or significant atrial septal aneurysm
	Presence of LA thrombus, vegetation or mass
	Presence of PFO associated with clinical symptoms

In the United States, mitral clip is approved for the use in degenerative mitral regurgitation. Approved indication:

Significant symptomatic degenerative mitral valve disease with mitral regurgitation ≥ 3+ in patients who have too high a risk for surgery.

In the United States, as of now, mitral clipping for functional mitral regurgitation is done within clinical trials such as the COAPT trial.