Abstract
Mitral regurgitation is the most common valvular lesion in the developed world, with increasing prevalence, morbidity, and mortality. The experience with surgical mitral valve repair or replacement is very well-validated. However, more than 45% of these patients get denied surgery due to an elevated risk profile and advanced disease of the left ventricle at the time of presentation, promoting the need for less invasive transcatheter options such as transcatheter repair and transcatheter mitral valve replacement (TMVR). Early available TMVR studies have shown promising results, and several dedicated devices are under clinical evaluation. However, TMVR is still in the early developmental stages and is associated with a non-negligible risk of periprocedural and post-procedural complications. In this review, we discuss the current challenges facing TMVR and the potential TMVR-related complications, offering an overview on the measures implemented to mitigate these complications, and future implications.
Highlights
Mitral regurgitation (MR) is the most common valvular disease in the developed world and is associated with high morbidity and mortality
This review offers a brief insight on the current challenges, potential complications of transcatheter mitral valve replacement (TMVR), and the measures available to mitigate these complications
In the TMVR case series of 23 consecutive patients undergoing mitral ViV by Cheung et al [18], one patient was readmitted with heart failure, and echocardiography showed 5-mm valve migration to the left atrium with severe intervalvular regurgitation that required a second uneventful TA TMVR
Summary
Mitral regurgitation (MR) is the most common valvular disease in the developed world and is associated with high morbidity and mortality. Due to the high risk associated with surgical interventions, and the level of advanced disease in this patient population, more than 49% of MR patients get rejected from surgical mitral valve replacement [5, 6]. This creates an unmet clinical need and a push for novel less invasive percutaneous mitral valve treatment alternatives— whether repair or replacement—with less periprocedural mortality and good clinical outcomes [7, 8]. Prosthetic valve embolization has not been reported in the surgical literature, and it has been described as a unique
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