Mitral valve repair: MitraClip and emerging techniques

Percutaneous mitral valve repair has emerged as an alternative to surgery for patients with significant symptomatic mitral regurgitation (MR) and prohibitive risk for surgical mitral repair or replacement. The MitraClip system consists of three major components: a 24-Fr steerable guiding catheter, the clip delivery system (CDS), and the MitraClip device. The first MR surgical treatment concept to be adapted for percutaneous use was the double-orifice or edge-to-edge repair. The edge-to-edge repair concept led to the development of the MitraClip. This device replicates the surgical repair by mechanically grasping the mitral leaflet free edges. Transcatheter mitral valve replacement (TMVR) as a therapy for functional mitral regurgitation (FMR) is also developing, with several different devices having first in human experience in the last 2 years. Transcatheter mitral repair and replacement interventions will become complementary solutions to accommodate the variability of the disease.