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Table 2. Transcatheter mitral valve replacement devices
Valves in clinical Shape/Frame Anchoring system Valve position Access
evaluation
CardiAQ TMVR Circular, nitinol, self-expandable Mitral annulus capture with native Supra-annular Transapical/transeptal
valve leaflet engagement valve position access
System
(Edwards
Lifesciences)
EVOQUE TMVR Circular, nitinol, self-expandable Mitral annulus capture with native Supra-annular Transeptal access
valve leaflet engagement valve position
System
(Edwards
Lifesciences)
SAPIEN M3 System Shape memory, nitinol, self- External anchor Supra-annular Transeptal access
(Edwards expandable valve valve position
Lifesciences)
Cardiovalve TMVR Circular, nitinol, self-expandable Mitral annulus capture with native Supra/Infra- Transseptal access
valve leaflet engagement annular position
System
(Cardiovalve Ltd.)
Tiara TMVR D-shaped, nitinol, self-expandable Fibrous trigone capture with native Intra-annular Transapical access
valve leaflet engagement valve position
System
(Neovasc Inc.)
Tendyne Mitral D-shaped (outer stent) and circular Apical tether Intra-annular Transapical access
(inner frame), nitinol, self- valve position
Valve System
(Abbott expandable valve
Laboratories)
INTREPID TMVR Circular, nitinol, doble stent, self- Radial force and subannular cleats Intra-annular Transeptal/Transapical
expandable valve valve position access
System
(Medtronic)
Caisson TMVR D-shaped, nitinol, self-expandable External anchor; Mitral annulus Supra-annular Transeptal access
valve capture with engagement at valve position
System
subannular fibrous groove
(LivaNova)
HighLife TMVR Circular, nitinol, self-expandable External anchor; Valve in subannular Intra-annular Transapical access
valve mitral ring valve position
System
(HighLife Medical)
Cephea TMVR Circular, nitinol, self-expandable External anchor; Valve in subannular Supra/Infra- Transapical/transatrial
valve mitral ring annular position access
System
(Cephea Valve
Technologies)
AltaValve TMVR Circular, nitinol, self-expandable Atrial anchoring Supra-annular Transapical/transeptal
valve valve position access
System
(4C Medical
Technologies)

(LVOT), complexity in planning the intervention, and the size/complexity in the delivery system have
slowed down its development compared to transcatheter aortic valve replacement. Nonetheless, TMVR has
gradually emerged as an alternative non-surgical treatment option for patients with symptomatic MV
[39]
diseases who are deemed because of their high or inoperable surgical risk . Its broad spectrum of
applicability in MV diseases has played a role for its implantation: from native valve mitral regurgitation to
“valve in valve” in degenerated bioprosthetic valves, “valve in annuloplasty ring”, or valve in severe mitral
annular calcification .
[40]
Different transcatheter devices have been designed for the treatment of MR but most TMVR technologies
[33]
are still in their early experience in safety and feasibility trials . Characteristics of the main TMVR devices
are summarized in Table 2 and Figure 4 [37,38,41-45] . In any case, some important considerations should be taken
into account before planning TMVR.