Mitral regurgitation approaches

Of the myriad percutaneous approaches currently proposed for the treatment of mitral regurgitation, the MitraClip (E-valve , Menlo Park, CA) and CARILLON Mitral Contour System (Cardiac Dimension , Kirkland, WA) have recently received CE Mark approval in Europe but none by the U.S. FDA. 

Placement of an annuloplasty ring is a common surgical approach for treatment of mitral regurgitation. There are currently a number of novel devices designed to simulate suture mitral annuloplasty surgery percuta-neously. All are currently in preclinical and early pilot clinical phase of development. 

Interventional cardiology no longer refers to just percutaneous coronary procedures. Peripheral vascular procedures are now a well-established part of the armamentarium. Perhaps the most exciting innovation in the interventional domain is percutaneous valvular repair for treatment of aortic stenosis and mitral regurgitation. This area has the potential to be transformative. Finally, in the field of electrophysiology, percutaneous ablation to isolate the pulmonary veins in patients with atrial fibrillation achieves success in the majority of patients. Whether this procedure will replace antiar-rhythmic therapy as a first-line approach remains to be seen, but for time being this approach at the very least can offer dramatic symptomatic relief for debilitated patients. 

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