Chapter 22 - Percutaneous Mitral Valve Repair Techniques

Abstract

This chapter describes established and emerging percutaneous mitral valve repair techniques. The goal of any percutaneous procedure is to achieve a durable correction of mitral disease with clinical efficacy similar to that of well-established open surgical interventions. Knowing which patients will benefit most from percutaneous approach and which approach to apply is exceedingly challenging given the complex and varied pathophysiology and anatomy of mitral valve disease. Surgical risk is often prohibitive given that mitral valve disease is both caused by and develops in parallel to many comorbidities that increase surgical risk. By applying concepts that have made surgical repair successful to the engineering of percutaneous technologies, restoring proper mitral valve function with catheter based techniques can be performed without many of the risks inherent to surgery. Percutaneous therapies therefore represent an expanding toolbox for the modern valvular heart disease center that strives to repair mitral valve disease in patients at all levels of surgical risk. Although catheter based repairs for MR are only approved in patients at prohibitive surgical risk, as more data is collected, percutaneous repair may one day be used as a viable option to surgical candidates who wish to avoid surgery.