This review summarizes the emerging landscape, device design challenges, and early clinical results of transcatheter mitral valve replacement for high-risk patients with mitral regurgitation.
TMVR for high-risk mitral regurgitation remains investigational; leaves open optimal device design and patient selection for randomized trials.
Mitral regurgitation (MR) is the second most common valvular heart disease in the western world with a prevalence in the USA alone of two to four million people. MR is age-dependent and hence the MR burden is expected to increase with the increase in life expectancy observed in Europe and the USA. Medical and surgical treatment has been the cornerstone of the treatment as untreated MR results in poor prognosis. However, only a fraction of patients are offered surgical treatment due to high risk. With the success of transcatheter aortic valve implantation (TAVI), many transcatheter options have emerged to provide a less invasive option for these patients. On the one hand, the repair options appear less invasive but tend to reduce the MR, while on the other hand the replacement options can eliminate the MR but could be more invasive. This article provides an overview of emerging transcatheter mitral valve replacement (TMVR) options currently available and summarises challenges in device design and patient selection and also early results.
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Patel et al. (2017) studied this question.
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