New safety, durability data for percutaneous mitral-valve repair system

AUGUST 14, 2009 | Shelley Wood

Washington, DC - New safety and durability data for the percutaneous MitraClip system (Evalve), an experimental device being tested for the treatment of mitral regurgitation, suggest that the device yields lasting improvements in mitral regurgitation, with at least two-thirds of patients treated surviving out beyond one year, without needing mitral-valve surgery or developing worsening mitral regurgitation [1]. Of the patients who ended up needing valve repair, there appeared to be no downsides to first having been treated with the device, investigators said.

The MitraClip [Source: Evalve]
"Surgical options were preserved," the authors, led by Dr Ted Feldman (Evanston Hospital, IL), write in the August 18, 2009 issue of the Journal of the American College of Cardiology.

The new data come from 107 patients treated as part of the nonrandomized EVEREST 1 and 2 studies. Results for both studies have previously been reported by heartwire, but the current paper includes larger numbers and additional details and follow-up. The device itself emulates the edge-to-edge repair technique pioneered surgically by Dr Ottavio Alfieri, in which the free edge of the anterior mitral-valve leaflet is joined to the posterior leaflet, creating a point of permanent coaptation and a double orifice./.../

Guidelines for Monitoring, Reporting, and Conducting Research on Medical Emergency Team

The majority of patients hospitalized with a cardiac arrest or requiring emergency transfer to the intensive care unit have abnormal physiological values recorded in the hours preceding the event.1–11 Many studies document that physiological measurements often are not made or recorded during this critical time of clinical deterioration.12–16 Such physiological abnormalities can be associated with adverse outcome.17–20 Measurements of abnormal physiology, including temperature, pulse rate, blood pressure, respiratory rate, hemoglobin, oxygen saturation by pulse oximetry, and deterioration of mental status, are therefore important to any system designed for early detection of physiological instability. At a minimum, these measurements must be obtained accurately and recorded with appropriate frequency. A system that both recognizes significantly abnormal values and triggers an immediate and appropriate treatment response is required. /...
Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
New guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) were published in November 2005.1,2 Publication followed a systematic evaluation of scientific evidence that culminated in the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations hosted by the American Heart Association (AHA) in January 2005.3,4 The new treatment recommendations from this meeting incorporated scientific advances made after publication of the 2000 guidelines and were published with the expectation that their worldwide implementation would help improve rates of survival from cardiac arrest and other life-threatening cardiopulmonary emergencies.
A new cycle of evidence evaluation has begun and is expected to be completed in 2010 with the publication of new and revised treatment recommendations. These recommendations will once again reflect the scientific knowledge gained during the intervening period. As the cycle begins, a unique opportunity exists to identify areas in greatest need of clinical research, with the expectation that key questions asked today may be answered in time for the 2010 guidelines. To this end, valuable information was obtained during the evidence evaluation process that led to the 2005 guidelines. Experts appointed to review specific resuscitation topics were asked not only to summarize the existing science but also to identify knowledge gaps. As a result, experts identified knowledge gaps in 276 preassigned topics. We have compiled and organized these knowledge gaps and, through a process of consultation and consensus, identified areas of priority for clinical research.