Mitral regurgitation percutaneous treatment

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. 

Despitetheselimitations, CARILLON Mitral Contour System has recently received CE Mark approval. More clinical experience is clearly warranted to further assess the role of percutaneous annuloplasty via coronary sinus remodeling in the treatment of mitral regurgitation. 

Alec Vahanian. 12-Month interim results of the percutaneous MONARC system for the treatment of functional mitral regurgitation. The Evolution Study. Presented at TCT 2008. 

Rogers JH, Macoviak JA, Rahdert DA, et al. Percutaneous septal sinus shortening a novel procedure for the treatment of functional mitral regurgitation. Circulation 2006 113 2329-34. 

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. 

Indications for surgical intervention include regurgitation with NYHA lll-IV symptoms or NHYA >11 with atrial fibrillation refractory to conservative treatment. Several surgical techniques are effective, The Alfieri stitch or edge to edge technique is of interest because one of the percutaneous mitral valve repair techniques is based on an equivalent principle (29,30). Currently two methods for transcatheter mitral valve repair are investigated in clinical trials ... 

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