Transcatheter edge-to-edge mitral valve repair in mitral regurgitation: current status and future prospects

ABSTRACT

Introduction

Mitral regurgitation (MR) is associated with substantial morbidity and mortality. Within the past 15 years, mitral valve edge-to-edge repair (M-TEER) has developed from an experimental approach to a guideline-recommended, safe, and effective treatment option for patients with severe primary or secondary mitral regurgitation.

Areas covered

This review covered relevant publications of M-TEER and summarizes the development of M-TEER devices within the last 15 years. It outlines anatomical challenges which drove the evolution of M-TEER devices, provides an overview about the current state of clinical application and research, and offers an outlook into the future of transcatheter mitral valve treatment.

Expert opinion

The development and refinement of new M-TEER device generations offer the possibility to treat a wide range of mitral valve anatomies. Choosing the best device for the individual anatomic properties of the patients and considering comorbidities is the key to maximized MR reduction, minimalized complication rates, and thus optimized postinterventional prognosis. Independent from prognostic implications, quality of life has become an important patient-centered outcome that can be improved by M-TEER in virtually all patients treated.

KEYWORDS:

• Mitral regurgitation
• edge-to-edge repair
• MitraClip
• PASCAL
• percutaneous mitral valve repair
• transcatheter mitral valve repair
• M-TEER

Article highlights

• Timeline of M-TEER

• State of the art M-TEER devices

• Improvement of quality of life and organ function by M-TEER

• Future challenges and developments in the field of M-TEER and transcatheter mitral valve treatment.

Declaration of interest

M Orban has received speaker fees from Tomtec Imaging System. D Braun has received speaker honoraria from Abbott Vascular. S Higuchi has received lecture fees from Medtronic Japan, Daiichi Sankyo, and Ono Pharmaceutical Company. Martin Orban has received speaker honoraria from Abbott Medical, AstraZeneca, Abiomed, Bayer vital, BIOTRONIK, Bristol Myers Squibb, CytoSorbents, Daiichi Sankyo Deutschland, Edwards Lifesciences Services, and Sedana Medical. M Näbauer has received speaker honoraria from Abbott Vascular. J Hausleiter has received grants and personal fees from Abbott Vascular, and grants and personal fees from Edwards Lifesciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.