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Mitral regurgitation (MR) is a highly prevalent valvular heart disease, particularly among elderly patients. In recent years, transcatheter mitral valve interventions have emerged as an alternative to surgery for selected high-risk patients. This review provides a comprehensive overview of current transcatheter mitral valve repair (TMVr) and replacement (TMVR) technologies. TMVr devices include indirect and direct annuloplasty systems, edge-to-edge leaflet approximation techniques (e.g., MitraClip, PASCAL, DragonFly), and transapical chordal repair platforms (NeoChord, HARPOON). Each strategy is tailored to address specific anatomical and pathophysiological mechanisms underlying MR. TMVR systems—including Tendyne, Intrepid, Cardiovalve, SAPIEN M3, and AltaValve—are currently under investigation, offering promising alternatives for patients with complex anatomy or contraindications to repair. Ultimately, TMVr and TMVR should be viewed as complementary strategies, with therapeutic choice guided by anatomical, clinical, and procedural considerations to achieve optimal and durable MR reduction.

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Trans-Catheter Interventions for Native Mitral Valve Regurgitation

  • 章节

  • 发表日期：

    2026年

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  • Andrea Marrone,
  • Alfonso Ielasi

摘要

Mitral regurgitation (MR) is a highly prevalent valvular heart disease, particularly among elderly patients. In recent years, transcatheter mitral valve interventions have emerged as an alternative to surgery for selected high-risk patients. This review provides a comprehensive overview of current transcatheter mitral valve repair (TMVr) and replacement (TMVR) technologies. TMVr devices include indirect and direct annuloplasty systems, edge-to-edge leaflet approximation techniques (e.g., MitraClip, PASCAL, DragonFly), and transapical chordal repair platforms (NeoChord, HARPOON). Each strategy is tailored to address specific anatomical and pathophysiological mechanisms underlying MR. TMVR systems—including Tendyne, Intrepid, Cardiovalve, SAPIEN M3, and AltaValve—are currently under investigation, offering promising alternatives for patients with complex anatomy or contraindications to repair. Ultimately, TMVr and TMVR should be viewed as complementary strategies, with therapeutic choice guided by anatomical, clinical, and procedural considerations to achieve optimal and durable MR reduction.