The Future of Transcatheter Therapy for Mitral Valve Disease

The develop percutaneous treatments for mitral regurgitation (MR) have been based on established surgical procedures. Most are based in some way on mitral annuloplasty. Indirect angioplasty utilizing coronary sinus and leaflet repair with the MitraClip device have the most development and clinical application. More recently, after the success of transcatheter aortic valve replacement, transcatheter mitral valve replacement has emerged. A critical unanswered question is what the relative roles of valve repair and valve replacement will be. The largest experience in practice is with MitraClip leaflet repair. The evidence base for the development of these novel therapies includes some data in surgical candidates, and registry studies that have been done predominantly in high risk populations.