Percutaneous mitral valve repair

Introduction

Mitral regurgitation (MR) is the second cause of valvular intervention in Europe. The continuous ageing of the population is usually accompanied by a greater comorbidity, frailty and, therefore, a higher surgical risk that has made it necessary to develop minimally invasive techniques for the treatment of valvular disease. A clear example is the percutaneous management of aortic stenosis that has achieved excellent success rates. However, mitral valve disease has not had such good results due to the complexity of the anatomy, and to the fact that many times there are several coexisting underlying mechanisms of the regurgitation which hinders not only the surgical management but also the newer percutaneous techniques.

The development of new techniques with promising results in this setting might change the management of this problem in the coming years. Therefore, knowledge of these technologies and their limitations, the mastery of interventional techniques, integration of different imaging techniques and the adequate selection of the patients are necessary to obtain good and lasting results.

This review aims to provide an update of the percutaneous techniques available and under development for mitral percutaneous repair, summarising the results of the main studies related to this exciting field.

The mitral valve anatomy...