We read with interest the article by Adamo et al1 exploring the differences in outcome between patients with disproportionate and proportionate secondary mitral regurgitation (SMR) undergoing edge-to-edge percutaneous mitral valve repair using the MitraClip system.
Grayburn et al2 hypothesised that the opposing results from the COAPT and MITRA-FR trials could be explained by the different patient populations. Patients with disproportionate SMR were believed to benefit from the MitraClip, and those with proportionate SMR were thought not to respond. This offered an exciting explanation that could lead to enhanced patient selection when considering who may benefit from the MitraClip ...
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