Over the past several years, developmental efforts to achieve percutaneous catheter-based therapies for valvular heart disease have allowed the first pulmonic and aortic transcatheter valve replacement respectively in year 2000 and 2002. Regarding mitral regurgitation, a variety of catheter-based percutaneous approaches have been
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Over the past several years, developmental efforts to achieve percutaneous catheter-based therapies for valvular heart disease have allowed the first pulmonic and aortic transcatheter valve replacement respectively in year 2000 and 2002. Regarding mitral regurgitation, a variety of catheter-based percutaneous approaches have been developed. The most studied device is the
MitraClip® (Evalve, Inc., Menlo Park, CA, USA) which is used to realise a percutaneous edge-to-edge mitral repair, resulting in a double-orifice mitral valve. The first prospective registry results in over 100 patients are encouraging. EVEREST II is currently randomising patients to either percutaneous approach or standard surgical repair with clinical and echographic safety and efficacy endpoints. Devices dedicated to coronary sinus annuloplasty such as
the Edwards MONARC system™ (Edwards Lifesciences, Irvine, CA, USA),
the Carillon™ (Cardiac Dimensions, Inc., Kirkland, WA, USA) and
the Viacor PTMA™ (Viacor, Inc., Wilmington, MA, USA) are investigated in ongoing safety and efficacy trials. To address some of the potential limitations of indirect annuloplasty via the coronary sinus, direct approaches to the mitral annulus are being developed such as the
Mitralign device (Mitralign, Inc., Tewksbury, MA, USA). All these transcatheter approaches may offer treatment options for high surgical risk patients. Treatment modalities for mitral regurgitation remain complex due to a wide disease spectrum and appropriate patient selection is the cornerstone for success. Percutaneous treatment of mitral regurgitation seems to be a promising approach, but is still at an early stage of development.
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