Transcatheter mitral valve replacement: there is still work to be done

Antonio L Bartorelli; Giovanni Monizzi; Angelo Mastrangelo; Luca Grancini; Franco Fabbiocchi; Edoardo Conte; Marco Moltrasio; Daniele Andreini

doi:10.1093/eurheartjsupp/suac098

Transcatheter mitral valve replacement: there is still work to be done

Eur Heart J Suppl. 2022 Nov 12;24(Suppl I):I16-I21. doi: 10.1093/eurheartjsupp/suac098. eCollection 2022 Nov.

Authors

Antonio L Bartorelli^{1

2}, Giovanni Monizzi¹, Angelo Mastrangelo¹, Luca Grancini¹, Franco Fabbiocchi¹, Edoardo Conte^{1

3}, Marco Moltrasio¹, Daniele Andreini^{1

2}

Affiliations

¹ Centro Cardiologico Monzino, IRCCS.
² Department of Biomedical and Clinical Sciences, University of Milan.
³ Department of Biomedical Sciences for Health, University of Milan, Milan.

Abstract

Transcatheter mitral valve replacement (TMVR) is a novel therapeutic option for patients with severe mitral regurgitation (MR) at high or prohibitive surgical risk. Most TMVR technologies under investigation use either a trans-apical or a trans-septal approach via dedicated multistep anchoring systems. Transcatheter mitral valve replacement offers several potential advantages over transcatheter repair, notably a greater and more sustained MR reduction. At the same time, significant engineering challenges and potential disadvantages must be acknowledged. Preclinical and clinical studies have shown promising results, demonstrating TMVR feasibility. Nevertheless, further development, testing, and trials are needed before considering TMVR as a definitive therapeutic option for MR in a wide range of anatomical scenarios.

Keywords: Mitral regurgitation; Mitral valve; Transcatheter mitral valve replacement.