Randomized Comparison of Percutaneous Repair and Surgery for Mitral Regurgitation: 5-Year Results of EVEREST II.

Background: In EVEREST II (Endovascular Valve Edge-to-Edge Repair Study), treatment of mitral regurgitation (MR) with a novel percutaneous device showed superior safety compared with surgery, but less effective reduction in MR at 1 year.

Objectives: This study sought to evaluate the final 5-year clinical outcomes and durability of percutaneous mitral valve (MV) repair with the MitraClip device compared with conventional MV surgery.

Methods: Patients with grade 3+ or 4+ MR were randomly assigned to percutaneous repair with the device or conventional MV surgery in a 2:1 ratio (178:80).

Diagnostic and Prognostic Use of Stress Echocardiography and Radionuclide Scintigraphy.

Stress echocardiography and radionuclide scintigraphy are effective diagnostic and prognostic techniques in patients with known or suspected coronary artery disease (CAD), myocardial infarction (MI), chronic left ventricular dysfunction (LVD), and those undergoing noncardiac surgery. Both are sensitive and specific for the detection and extent of CAD. Negative tests confer a high negative predictive value for cardiac events irrespective of clinical risk.