Prospects for the percutaneous repair of the mitral valve. (August 2010) - Goldberg, Steven L
Despite recent advances, the selection of appropriate treatment options in patients with mitral regurgitation, especially those with heart failure, represents an important clinical problem. Although mitral regurgitation is an independent predictor of worse prognosis in patients with heart failure, patients are commonly denied cardiac surgery repair procedures, owing to perceived high procedural risk and questions as to their clinical value. As a result, several less invasive techniques for percutaneous mitral valve repair have been developed and are under clinical evaluation. One of the techniques for percutaneous mitral repair is based on a surgical procedure developed by Alfieri, the so-called bow-tie mitral valve configuration. Other devices are designed to be implanted within the coronary sinus, allowing for tensioning to plicate the posterior leaflet and to reduce the septal–lateral dimension of the mitral annulus. Some of the strategies are aimed at the reduction of the annular dimensions using a ventricular or an atrioventricular approach.