Abstract
Functional mitral regurgitation (FMR) occurs in the myopathic ventricle when papillary muscle displacement with leaflet tethering and/or annular dilatation causes valvular insufficiency. The resultant left ventricular (LV) volume overload then potentiates further negative remodeling. Current surgical management of FMR involves either mitral valve repair (MVr) or mitral valve replacement (MVR), each of which are associated with significant perioperative risk and poor late outcomes. This has led to the development of novel methods of reshaping the left ventricle and mitral valve to treat FMR while minimizing the operative risk and preventing negative ventricular remodeling. While off-pump devices for mitral leaflet repair including percutaneous mitral clips, trans-apical neochordae and percutaneous mitral replacement devices are under investigation, this report reviews the current status of both passive and active off-pump ventricular and mitral annular reshaping devices.
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