Recent developments in percutaneous mitral valve treatment

ABSTRACT

In recent years, various percutaneous techniques have been introduced for the treatment of mitral regurgitation (MR), including direct leaflet repair, annuloplasty and left ventricular remodeling. Percutaneous mitral repair targets both primary degenerative and secondary mitral valve regurgitation and may be considered in selected high-surgical-risk patients. The assessment of mitral functional anatomy by echocardiography and computed tomography is crucial when selecting the appropriate repair strategy, according to the regurgitant valve lesion and the surrounding anatomy. The ongoing clinical use of new devices in annuloplasty and percutaneous mitral valve replacement is a promising new scenario in the treatment of MR that goes beyond the conventional surgical approach.

KEYWORDS:

• Mitral regurgitation
• mitral valve repair
• percutaneous valve repair
• percutaneous valve devices
• cardiac imaging

Key issues

• Percutaneous mitral valve therapy is an emerging therapeutic procedure for the treatment of mitral regurgitation in high-surgical-risk patients

• Percutaneous mitral valve therapy mimics surgical repair techniques, including leaflet repair, annuloplasty and left remodeling approaches

• Echocardiography and computed tomography imaging are essential for functional anatomy assessment, and the selection and monitoring of percutaneous procedures

• Percutaneous valve replacement and combined techniques will be the next step in the revolution in mitral valve treatment