Atrioventricular valve disease: challenges and achievements in percutaneous treatment

Percutaneous treatment of atrioventricular (AV) valve disease has long been restricted to therapy of mitral stenosis, and was only lately expanded to mitral regurgitation. 15 years ago the MitraClip edge to edge repair was first applied to human pathology. In Europe, German centers were the first to widely adopt this technique in patients with mitral regurgitation and high or inappropriate risk for surgery. Given the exponential rise in implantation procedures, expertise of the operators and investigator initiated investigations substantially contributed to improvements in procedural processes and patient selection. Meanwhile, additional techniques to repair the mitral and tricuspid valve were introduced to German interventionalists, both reconstructive techniques as well as first experiences with transcatheter implantation of mitral valve bioprostheses. Of note, specialized Heart Valve referral Centers catalyzed the adoption of these techniques. This review summarizes the contributions of German Heart Centers to recent developments in percutaneous therapy of AV valve disease.