Multicentre Study of MITRACLIP® Transcatheter Mitral Valve Repair in Patients With Severe Primary Mitral Regurgitation Eligible for High-risk Surgery

Inclusion Criteria: Primary Mitral Regurgitation grade 3+ or 4+ * Patients in class II to IV NYHA * Mitral valve anatomy appropriate to MitraClip® therapy and mitral valve surgery * Adult patients judged eligible for mitral valve surgery by the local heart team but at high surgical risk defined as: age ≥ 75 years and STS score ≥ 6 % or one frailty index or one major organ system compromise or one possible procedure-specific impediment (using MVARC definitions) ; or age \< 75 years and STS score \> 8 % or at least one other high-risk criterion following the MVARC definitions; or age \> 80 years and judged at high risk for surgery by the local heart team * Isolated Mitral valve pathology * If revascularization procedures are required, they must be performed more than 30 days from intervention (D0) * Patients affiliate to social security Non-inclusion Criteria: * Life expectancy \< 1 year due to non-cardiac conditions * Secondary Mitral regurgitation * Evolving endocarditis or active endocarditis or inflammatory disease in the last 3 months * Patient who cannot tolerate procedural anticoagulation or post procedural antiplatelet regimen * Rheumatic mitral valve disease * Evidence of intracardiac, inferior vena cava or femoral venous thrombus * Valve anatomy not compatible with MitraClip® implantation (cf. colum 3 table 3 page 57) * Stroke or transient ischaemic event within 30 days before D0 * Modified Rankin Scale ≥4 disability (appendix 9) * TAVR within 30 days before D0-Un…