Mitral Valve Interventions in Structural Heart Disease

Analyze the current state of the art and the future perspectives of mitral interventions in clinical setting.

A systematic and critical review of the new mitral percutaneous therapies and imaging technologies is the basis to adopt the right treatment for each patient according to specific valve dysfunction and clinical presentation, waiting for definitive guidelines. While surgical mitral repair will remain the gold standard for low-risk healthy patients with degenerative mitral regurgitation (DMR), transcatheter mitral valve repair is becoming first line therapy in high risk patients with functional mitral regurgitation (FMR). The introduction of transcatheter mitral valve replacement will expand indications for advanced DMR and FMR in inoperable patients. The introduction of transcatheter mitral interventions is changing the mitral therapy scenario. Mitral interventionalists might evolve into hybrid professional figures able to offer a tailored approach for each patient, including surgical and percutaneous approaches, depending on the anatomo-functional status of the valve, to clinical conditions, and to the timing of the intervention.