In Search of Best Practices for Patients With Heart Failure and Secondary Mitral Regurgitation: An Evaluation of the Inova Heart Failure Treatment Algorithm

This study is evaluating a structured treatment algorithm for patients who have both heart failure and a leaky heart valve called secondary mitral regurgitation. The algorithm combines optimized medical therapy with a minimally invasive valve repair procedure (MitraClip). The goal is to determine the best sequence and combination of treatments. **You may be eligible if...** - You have heart failure with reduced ejection fraction (EF ≤ 50%) and a leaky mitral valve (≥ 2+ severity) - Your heart failure symptoms are moderate to severe (NYHA class II, III, or ambulatory IV) - Your heart team has determined that open heart surgery is not appropriate for you - Your mitral valve can likely be repaired with the MitraClip device - You have been appropriately treated for any underlying coronary artery disease **You may NOT be eligible if...** - Your mitral valve leakage is caused by a structural valve problem (as opposed to heart failure) - Your heart is too enlarged (LVESD > 70 mm) for this approach - Femoral vein access for the procedure is not feasible Talk to your doctor to see if this trial is right for you.