Transcatheter Mitral Valve Repair: MitraClip and Emerging Technologies

Mitral regurgitation (MR), the most common valvular disease, can result from abnormalities in the valve apparatus (primary MR) or arise secondary to left ventricular, left atrial or annular deformation in the setting of coronary artery disease or cardiomyopathy (functional MR). Functional MR (FMR) accounts for approximately two-thirds of all MR cases. Mitral valve insufficiency has a tendency to progress over time (“MR begets MR”) and portends a poor prognosis without treatment. Echocardiography is central to MR diagnosis and management. Surgical correction of severe MR is the treatment of choice for primary MR. Conversely, surgical correction of FMR is associated with suboptimal outcomes. Moreover, a substantial proportion of patients with MR are not referred for surgery due to excessive procedural risk. Consequently, effective, low-risk, transcatheter-based solutions are rapidly evolving.