The Prevalence and Impact of Glycaemic Variability on Cardiac Surgery Patients in an Australian Hospital Setting

searched for original published studies from January 2000 to March 2013. Search terms used were ‘percutaneous’ OR ‘transcutaneous’ OR ‘transcatheter’ OR ‘catheter-based’ OR ‘endovascular’ OR ‘trans-septal’ AND ‘MV repair’ OR ‘edgeto-edge technique’ OR ‘Alfieri’s technique’ OR ‘double-orifice technique’ OR ‘MitraClip’ OR ‘mitral clip’. Results: Of 111 publications identified, 12 publications with the most complete dataset were included for data extraction. Immediate procedural success ranged from 72 to 100% and weighted mean procedural mortality was 3.3% (range 0–7.8%). There was a significant improvement in haemodynamic profile and functional status after implantation. At 6–12 month follow up, 61–99% of patients reported grade 2 + MR. One year survival ranged from 75 to 90%. No long term outcomes have been reported for high surgical risk patients. Discussion:Despite the high risk patient cohort, theMitraClip is associated with comparable MV repair mortalities in the STS Adult Cardiac Database (1.8% and 3.7% in NHYA III and IV respectively) and measurable improvement on echocardiography. The current evidence suggests that MitraClip can be implanted with reproducible safety and feasibility profile in high surgical risk patients with severe MR. Further prospective trials with midto long-term follow-up are required.