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This is the first comprehensive review of the edge-to-edge technique for mitral repair, which was introduced into the surgical armamentarium in 1991 by one of the authors, Ottavio Alfieri. The surgical technique employed in edge-to-edge repair today provides the basis for the only reliable method of percutaneous correction of degenerative mitral regurgitation. The book traces the evolution of the edge-to-edge technique from a surgical to a percutaneous approach, documenting indications, contraindications, technical aspects, controversies and clinical outcomes. Detailed attention is devoted to the MitraClip procedure, which reproduces the Alfieri stitch percutaneously and has to date been used in more than 20,000 patients worldwide. The state of the art in MitraClip therapy is described, with clear explanation of when and how to use the MitraClip system. The reader will learn all aspects of percutaneous edge-to-edge repair, which is recommended for use in carefully selected patients in the new ESC/EACTS guidelines for the management of valvular heart disease and in the ESC guidelines on heart failure. The group at San Raffaele Hospital, Milan, has accumulated by far the largest experience in the world with the technique and over the years has been very active in its promotion and scientific evaluation. This book reflects that depth of knowledge and will be of great interest to cardiac surgeons and interventional and clinical cardiologists.
List of contents
1 The genesis of the edge-to-edge technique.- 2 The principle: from computational model to clinical validation.- 3 Technical aspects: sternotomy and minimally invasive surgery.- 4 Is there a role for the edge-to-edge technique in robotic mitral valve repair?.- 5 Echocardiographic assessment of a double orifice mitral valve: tips and tricks.- 6 The early phase of clinical application: lessons learned.- 7 Early and long-term results of the EE repair.- 8 Transaortic edge-to-edge technique in patients with hyperthrophic obstructive cardiomyopathy.- 9 Mitral stenosis after EE repair: is it an issue?.- 10 Current surgical indications and contraindications.- 11 The case of surgical EE repair without annuloplasty: now we know.- 12 Evolution of EE repair: from surgery to percutaneous.- 13 State of the art in Mitraclip therapy: who, when and how.- 14 Clinical results of the percutaneous EE repair: lights and shadows.- 15 Future perspectives on percutaneous EE repair.- 16 Conclusions.
