AVJ-514 Trial

severity or improves clinical outcomes in degenerative MR. Degenerative MR is therefore more amenable to surgical therapy. However, many patients are not offered MV surgery because of their high surgical risk status. A percutaneous MV repair device (overseas brand name MitraClip®, Abbott Vascular, Santa Clara, CA, USA) has shown promise in reducing MR severity and improving clinical and functional outcomes and quality of life (QOL) in patients with severe MR.3–5 The MitraClip® device, which simulates the Alfieri technique,6 grasps and coapts the MV leaflets, resulting in fixed approximation of the leaflets throughout the cardiac cycle. This percutaneous procedure is performed without the need P rimary (or degenerative) mitral regurgitation (MR) is caused by a structural or degenerative abnormality of the mitral valve (MV) involving the leaflets, chordae tendineae, papillary muscles, or mitral annulus. Secondary MR, also referred to as functional MR, occurs in the absence of primary MV disease, usually from left ventricular (LV) dysfunction. Contrary to degenerative MR, functional MR is associated with a worse prognosis, and the benefits of conventional MV surgery are uncertain.1,2 In functional MR, optimal medical therapy, cardiac resynchronization, or revascularization may decrease MR severity if reverse remodeling of the LV occurs. There is limited evidence that medical therapy directly decreases MR