title: Percutaneous and minimally invasive approaches to mitral valve repair for severe mitral regurgitation-new devices and emerging outcomes.
abstract: Mitral valve disease is common in the United States and around the world, and if left untreated, increases cardiovascular morbidity and mortality. Mitral valve repair is technically more demanding than mitral valve replacement. Mitral valve repair should be considered the first line of treatment for mitral regurgitation in younger patients, mitral valve prolapse, annular dilatation, and with structural damage to the valve. Several minimally invasive percutaneous treatment options for mitral valve repair are available that are not restricted to conventional surgical approaches, and may be better received by patients. A useful classification system of these approaches proposed by Chiam and Ruiz is based on anatomic targets and device action upon the leaflets, annulus, chordae, and left ventricle. Future directions of minimally invasive techniques will include improving the safety profile through patient selection and risk stratification, improvement of current imaging and techniques, and multidisciplinary education.
authors.forename: Fadi E
authors.initials: FE
authors.lastname: Shamoun
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Craner
authors.forename: Rita Von
authors.initials: RV
authors.lastname: Seggern
authors.forename: Gerges
authors.initials: G
authors.lastname: Makar
authors.affiliation: Mayo Clinic, Department of Anesthesiology, Arizona, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Ramakrishna
mesh_terms: D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D016896:Treatment Outcome