Percutaneous mitral valve repair and replacement

Percutaneous therapy options for mitral regurgitation (MR) were the first concepts in early stages of development over a decade ago. The earliest ideas were based on coronary sinus annuloplasty, since that seemed to be simple from a technical standpoint, and have the potential to mimic an established surgical procedure. MitraClip has eclipsed the field of devices in the area of catheter-based repair. Over 25, 000 patients have been treated with this device, compared with the next most commonly used device having been used in about 300 patients. The MitraClip device is a 4-mm-wide cobalt-chromium implant with two arms that are opened and closed with the use of the delivery system. The MitraClip device was approved for clinical use in Europe in 2008. A large experience with many thousands of patients was accrued since then. Numerous registries have been reported. The earliest concepts for percutaneous mitral repair were based on indirect annuloplasty via the coronary sinus.