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Ancona et al. Mini-invasive Surg 2020;4:79 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.80

Review Open Access

Intraprocedural guidance in percutaneous mitral
valve repair

Francesco Ancona , Stefano Stella , Cristina Capogrosso , Francesco Melillo , Giacomo Ingallina ,
1
1
1
1
1
Antonio Boccellino , Antonio Napolano , Eustachio Agricola 1,2
1
1
1 Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.
2 School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy.
Correspondence to: Dr. Francesco Ancona, Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, IRCCS San
Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy. E-mail: ancona.francesco@hsr.it
How to cite this article: Ancona F, Stella S, Capogrosso C, Melillo F, Ingallina G, Boccellino A, Napolano A, Agricola E.
Intraprocedural guidance in percutaneous mitral valve repair. Mini-invasive Surg 2020;4:79.
http://dx.doi.org/10.20517/2574-1225.2020.80
Received: 6 Aug 2020 First Decision: 21 Sep 2020 Revised: 23 Sep 2020 Accepted: 10 Oct 2020 Published: 6 Nov 2020
Academic Editor: Azeem Latib Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Percutaneous mitral valve intervention is emerging as a valid alternative for patients affected by mitral
regurgitation. By addressing the pathophysiology, therapeutic options mainly target the leaflets, annulus or left
ventricle. The present review will cover the intraprocedural guidance of the most used approaches, such as edge
to edge repair, adjustable transapical beating-heart chordal implantation and percutaneous direct or indirect
annuloplasty. Intraprocedural monitoring relies on integration of fluoroscopy and echocardiography, and is based
on the continuous communication between the interventional imager and the interventional cardiologist.

Keywords: Mitral regurgitation, transcatheter mitral valve interventions, percutaneous edge to edge mitral valve
repair, percutaneous direct mitral valve annuloplasty, interventional echocardiography

INTRODUCTION
Percutaneous mitral valve intervention is emerging as an alternative for high-risk patients with mitral
regurgitation (MR) who are not suitable for conventional open-heart surgery. The current therapeutic
options available are classified according to the main physio-pathological targets namely the leaflets,
annulus and chordae tendinae.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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