Transcatheter mitral valve implantation

Introduction

Transcatheter mitral valve implantation (TMVI) techniques have been intensively developed during the last years as an alternative treatment option for patients with symptomatic mitral valve (MV) disease who are ineligible or at high risk for conventional open-heart surgery. In contrast to transcatheter aortic valve implantation, the interventional treatment of MV disease requires a more versatile approach due to the various etiologies of valvular dysfunction and the broad anatomical spectrum. The high level of complexity also makes technical developments and system engineering particularly challenging.

MV disease is the most common valvular heart disease worldwide, with primary (degenerative) and secondary (functional) regurgitation being the most common etiologies in developed countries and rheumatic heart disease in most other geographies. Left untreated, MV disease is linked to substantially increased morbidity and mortality. Treatment has long been exclusively based on surgical procedures such as valve repair or replacement. The limited applicability of open-heart surgery linked to high morbidity and mortality in elderly patients, especially those with impaired left ventricular function, has created a large therapeutic gap since up to 50% of the patients with MV disease are not referred for an intervention and remained untreated. 1, 21. Mirabel, M, et al....