Transcatheter mitral valve repair
- Ehrin J Armstrong, MD, MSc, FACC
Ehrin J Armstrong, MD, MSc, FACC
- Associate Professor Medicine
- University of Colorado School of Medicine
- Elyse Foster, MD
Elyse Foster, MD
- Professor of Clinical Medicine
- University of California, San Francisco
Transcatheter mitral valve repair (TMVR) is a minimally invasive technique for treatment of symptomatic chronic moderate-severe or severe mitral regurgitation (MR).
This article reviews TMVR, with a focus on the indications for treatment, patient selection, outcomes, and complications using the MitraClip device. (See 'Available technology' below.)
An overview of management of chronic MR and surgical treatment of chronic MR are presented elsewhere. (See "Management of chronic primary mitral regurgitation" and "Surgical procedures for severe chronic mitral regurgitation".)
Mitral regurgitation (MR) can be caused by a primary disease of the valve leaflets (so-called primary MR, which is most commonly caused by "degenerative" or myxomatous mitral valve disease in developed countries), or by secondary (functional) causes such as by adverse left ventricular remodeling from cardiomyopathy or coronary artery disease. (See "Pathophysiology of chronic mitral regurgitation" and "Clinical manifestations and diagnosis of chronic mitral regurgitation".)
While a number of technologies are in clinical development, an edge-to-edge leaflet repair device (the MitraClip) is currently the only US Food and Drug Administration (FDA) approved device for TMVR. The MitraClip, as well as the CARILLON mitral annuloplasty device, has CE Mark approval. (See 'Investigational technologies' below.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- AVAILABLE TECHNOLOGY
- CANDIDATES FOR TRANSCATHETER MITRAL VALVE REPAIR
- Echocardiographic criteria
- Determination of surgical risk
- OUTCOMES OF TRANSCATHETER MITRAL VALVE REPAIR
- Early results
- Comparison with surgical mitral valve repair
- Reduction in mitral regurgitation
- Left ventricular reverse remodeling
- Functional and quality of life improvement
- Use for secondary MR
- COMPLICATIONS OF TRANSCATHETER MITRAL VALVE REPAIR
- Device embolization or partial clip detachment
- Mitral stenosis
- Infective endocarditis
- INVESTIGATIONAL TECHNOLOGIES
- SUMMARY AND RECOMMENDATIONS