The therapeutic gold standard for the treatment of severe mitral regurgitation (MR) is elimination of MR by reduction of mitral annular anteroposterior (AP) diameter with direct surgical annuloplasty. However, open heart surgery is declined in many high-risk heart failure (HF) patients who are still symptomatic from MR despite medication.
During the last decade, transcatheter mitral valve repair (TMVr) approaches have earned merit in terms of reduction of MR. Despite excellent echocardiographic and clinical results after MitraClip® (Abbott Vascular, Santa Clara, CA, USA) or PASCAL (Edwards Lifesciences, Irvine, CA, USA) procedures, edge-to-edge TMVr has limitations with about 10-20% ...