Abstract
Mitral regurgitation is one of the most prevalent valvulopathies worldwide, and its surgical treatment is not feasible in all cases. The elderly and frail with several comorbidities and left ventricular dysfunction are often managed conservatively. Percutaneous treatment (repair or replacement) of the mitral valve has emerged as a potential option for those patients who are at a high risk for surgery. Mitral valve repair with the Mitraclip device proved both increased safety and mortality reduction in patients with severe mitral regurgitation. On the other hand, in the last decade, percutaneous mitral replacement opened new frontiers in the field of cardiac structural interventions. There are few mitral devices; some are in the early phase of development and some are waiting for CE mark of approval. The evolution of these devices was more complicated compared to the aortic technology due to the native mitral valve's complexity and access. This review aims to provide an overview of the current devices, their specific features, and their potential complications.
Highlights
Opposite to transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement (TMVR) is a much more complex procedure due to the mitral valve’s anatomy and shape, lack of calcification, and its relationship with adjacent structures
The present review aims to describe principal transcatheter mitral valves, focusing on their mechanism, anchoring design, and the potential complications that can occur during TMVR
The anchor is a D-shaped, self-expanding nitinol structure, which is implanted at the level of the native mitral annulus, and it is the backbone for the bioprosthesis (Table 2)
Summary
Livia Gheorghe 1, Jorn Brouwer 1, Dee Dee Wang 2, Nina Wunderlich 3, Bushra Rana 4, Benno Rensing 1, Frank Eefting 1, Leo Timmers 1 and Martin Swaans 1*. Received: 01 February 2020 Accepted: 05 October 2020 Published: 27 November 2020 Percutaneous treatment (repair or replacement) of the mitral valve has emerged as a potential option for those patients who are at a high risk for surgery. In the last decade, percutaneous mitral replacement opened new frontiers in the field of cardiac structural interventions. There are few mitral devices; some are in the early phase of development and some are waiting for CE mark of approval. The evolution of these devices was more complicated compared to the aortic technology due to the native mitral valve’s complexity and access.
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