Mechanics of mitral valve edge-to-edge-repair and mitraclip procedure

Shamik Bhattachary, Zhaoming He

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The edge-to-edge repair (ETER) technique has been used as a stand-alone procedure, or as a secondary procedure with ring annuloplasty for degenerative, functional mitral regurgitation, or for mitral regurgitation of other kinds of valvular etiologies. The percutaneous MitraClip technique based on ETER has been used in patients who are inoperable or at high surgical risk. However, adverse events such as residual mitral regurgitation, and clip detachment or fracture indicate that the mechanics underlying these procedures is not well understood. Therefore, current studies on mitral valve functionality and mechanics related to the ETER and MitraClip procedures are reviewed to improve the efficacy and safety of both procedures. Extensive in vivo, in vitro, and in silico studies related to ETER and MitraClip procedures along with MitraClip clinical trial results are presented and discussed herein. The ETER suture force and the mitral valve tissue mechanics and hemodynamics of each procedure are discussed. A quantitative understanding of the interplay of mitral valve components and as to biological response to the procedures remains challenging. Based on mitral valve mechanics, ETER or MitraClip therapy can be optimized to enhance repair efficacy and durability.

Original languageEnglish
Pages (from-to)135-145
Number of pages11
JournalJournal of Long-Term Effects of Medical Implants
Issue number1-2
StatePublished - 2015


  • Mechanics
  • Medical device
  • Mitral valve
  • Percutaneous repair


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