Transcatheter mitral valve repair

Transcatheter mitral annuloplasty

Mitral valve annuloplasty is routinely used during surgical mitral valve repair of degenerative or functional mitral regurgitation (MR). Annuloplasty techniques using percutaneous transcatheter approaches have been indirect or direct, based on their relation to the mitral annulus.

FOCUS BOX 1Mitral regurgitation
Mitral regurgitation (MR) contributes to significant morbidity and mortality. In degenerative MR, medical treatment may be insufficient and cardiac surgery has been the only effective option for decades. In functional MR, symptoms may be improved by medical treatment and, if indicated, cardiac resynchronization therapy (CRT). Transcatheter mitral valve repair techniques are increasingly used and can be an option for those patients who are not suitable for cardiac surgery.

Indirect mitral annuloplasty

In functional MR, an important surgical approach is placement of a mitral annuloplasty ring to reduce the annular circumference and obtain better coaptation of the mitral leaflets. Transcatheter indirect mitral annuloplasty methods are based on the parallel relationship of the coronary sinus to the mitral annulus. The anatomical proximity of the coronary sinus to the posterior mitral annulus, coupled with ease of percutaneous access to this large vein, has been the basis for the development of catheter-based mitral annuloplasty devices. However, the distance...