Transcatheter mitral valve repair (TMVR) is a minimally invasive procedure used as a treatment option for patients with symptomatic chronic moderate to severe, or severe mitral regurgitation (MR). The MitraClip is an edge-to-edge leaflet repair device and is currently the only device approved by the U.S. Food and Drug Administration for TMVR. MR is one of the most common valve lesions. Patients with chronic kidney disease (CKD) and MR usually have multiple comorbidities, increasing their surgical risk for valve replacement and making them possible candidates for TMVR by use of the MitraClip. The interaction between MR and the kidney is complex: MR can lead to abnormalities in hemodynamics and congestive heart failure, which may lead to or worsen CKD. Repair of the mitral valve may therefore be expected to have a favorable impact on kidney function in some patients. Conversely, kidney function plays an important role in cardiovascular disease, and it is well known that the outcomes of many procedures such as transcatheter aortic valve replacement (TAVR) are worse in patients with CKD than in the general population. Here we review the use of MitraClip and its application in patients with kidney disease.
Given the interrelationships between the heart and kidneys, it is plausible that repair of the mitral valve, including repair performed by the transcatheter approach, might have a favorable impact on kidney function in some patients in whom a component of the kidney disease is a consequence of decreased effective arterial volume.
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