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Scotti et al. Vessel Plus 2020;5:6 Vessel Plus
DOI: 10.20517/2574-1209.2020.68

Review Open Access

Patient selection for trans-catheter mitral valve
repair vs. replacement: ongoing indications and

glimpse to the future

Andrea Scotti , Michele Galasso , Alberto Margonato , Cosmo Godino 2
2
1
2
1 Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua Medical School, Padua 35128, Italy.
2 Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan 20132, Italy.
Correspondence to: Dr. Cosmo Godino, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute. Via Olgettina
60, Milan 20132, Italy. E-mail: godino.cosmo@hsr.it

How to cite this article: Scotti A, Galasso M, Margonato A, Godino C. Patient selection for trans-catheter mitral valve Repair
versus Replacement: ongoing indications and glimpse to the future. Vessel Plus 2020;5:6.
http://dx.doi.org/10.20517/2574-1209.2020.68

Received: 7 Nov 2020 First Decision: 3 Dec 2020 Revised: 3 Dec 2020 Accepted: 9 Dec 2020 Published: 21 Jan 2021

Academic Editor: Manel Sabate Copy Editor: Monica Wang Production Editor: Jing Yu
Received: First Decision: Revised: Accepted: Published: x
Abstract
Science Editor: Copy Editor: Production Editor: Jing Yu
Transcatheter therapies for patients with severe mitral regurgitation are increasingly performed in recent years.
While transcatheter mitral valve repair (TMVR) is now a consolidated intervention with > 100,000 procedures
performed worldwide, TMV replacement (TMVRpl) is in its early stages and can only be offered by a few centers.
The complexity of mitral valve anatomy requires careful evaluation when selecting the best approach and the most
suitable device. At present, the clinical experience with TMVRpl is still in a preliminary phase. Most of the patients
treated with this approach thus far are high-risk candidates who have undergone a very restrictive clinical and
anatomical selection. Therefore, it is difficult to correctly define which patients might benefit more from TMVRpl
than from TMVR. We review the clinical, pathophysiological, and technical factors to suggest when to prefer TMVR
instead of a replacement technique.

Keywords: Mitral regurgitation, transcatheter mitral valve repair, transcatheter mitral valve replacement

INTRODUCTION
Percutaneous procedures can be considered a safe alternative to surgical approaches in most patients
affected by severe mitral regurgitation (MR). Although transcatheter mitral valve repair (TMVR) is

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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