Key result
Transcatheter MR therapies like MitraClip rely predominantly on registry studies in high-risk populations.
This review highlights the development of transcatheter therapies for mitral regurgitation, emphasizing the ongoing question of the relative roles of valve repair versus replacement.
Evidence limited to high-risk registries should not yet change practice; leaves open repair-versus-replacement questions in broader populations.
The develop percutaneous treatments for mitral regurgitation (MR) have been based on established surgical procedures. Most are based in some way on mitral annuloplasty. Indirect angioplasty utilizing coronary sinus and leaflet repair with the MitraClip device have the most development and clinical application. More recently, after the success of transcatheter aortic valve replacement, transcatheter mitral valve replacement has emerged. A critical unanswered question is what the relative roles of valve repair and valve replacement will be. The largest experience in practice is with MitraClip leaflet repair. The evidence base for the development of these novel therapies includes some data in surgical candidates, and registry studies that have been done predominantly in high risk populations.
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Feldman et al. (2016) conducted a review in Mitral regurgitation. Transcatheter therapy was evaluated. Transcatheter therapies for mitral regurgitation, such as MitraClip, are currently supported predominantly by registry studies in high-risk populations.
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