Transcatheter Mitral Valve Interventions for Mitral Regurgit
Significant mitral regurgitation (MR) is the most common valvular disease in patients over 75 years old in the United States. However, many patients with severe MR are high-risk for surgical repair due to other significant comorbidities. Over the past decade, many transcatheter mitral valve devices have been studied that address different mechanisms of MR, but only a few have received Conformité Européene (CE) mark or Food and Drug Administration (FDA) approval. The Carillon, Cardioband, and Mitralign received CE mark for percutaneous mitral annuloplasty, while the Tendyne and SAPIEN 3 received CE mark and FDA approval, respectively, for transcatheter mitral valve replacement. Finally, NeoChord DS 1000 received CE mark for transcatheter chordal repair. Each of these devices is reviewed in detail including device indications, performance in clinical trials, anesthetic management, intraprocedural imaging guidance, and post-procedural complications. While percutaneous devices will appear and disappear from use, understanding the procedural considerations remains highly relevant as these key principles will apply to the next generation of transcatheter valve interventions.