Percutaneous mitral valve replacement

TRANSCATHETER MITRAL VALVE THERAPIES: REPLACEMENT VS. REPAIR

Several transcatheter mitral valve repair (TMVr) techniques, based on surgical repair techniques, are being simultaneously developed as a minimally invasive alternative for patients who are not candidates for surgery. Although the MitraClip is the only device approved by the U.S. Food and Drug Administration, other devices have received CE-mark approval for the treatment of mitral regurgitation, including the DS 1000 device (NeoChord, Inc., St. Louis Park, MN, USA), the Cardioband (Edwards Lifesciences, Irvine, CA, USA), the Carillon® (Cardiac Dimensions, Inc., Kirkland, WA, USA) and the Mitralign device (Mitralign, Inc., Tewksbury, MA, USA). Recently, two randomised trials comparing the MitraClip device in addition to optimial medical therapy versus medical therapy alone have reported disparate results. The Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) trial showed no benefit of MitraClip in patients with severe secondary MR on optimal medical treatment, while the COAPT trial demonstrated a significantly lower all-cause mortality and rehospitalisation within 24 months for heart failure in patients who underwent a MitraClip procedure 44. Stone GW, Lindenfeld J, Abraham WT, Kar S, Lim DS, Mishell JM, Whisenant B, Grayburn PA, Rinaldi...