Overview of the catheter-based methods for treatment of mitralregurgitation

Abstract

Mitral regurgitation or mitral insuffi ciency is the second most common valve pathology requiring a surgical treatment worldwide. It is characterized by an abnormal return of blood from the left ventricle to the left atrium during the systole. The incidence of mitral regurgitation increases in line with the rise in the life expectancy and the overall aging of the world population. According to the pathoanatomy and the mechanism of development, there are two main types of mitral regurgitation: a primary (degenerative) regurgitation and secondary (functional) regurgitation. In the fi rst type, there is organic damage to the valve and/or the valve apparatus, and in the second type, there is a secondary dysfunction of the mitral valve due to damage to the structure and/or the function of the left ventricle. The treatment of choice for the management of the mitral regurgitation is a surgical intervention. In recent years new high-tech transcatheter methods of treatment have been introduced in clinical practice. The most popular and proven method of treatment in patients who could not undergo classic cardiac surgery is the MitraClip edge-to-edge transcatheter approximation system. Other endovascular methods of treatment are percutaneous plasty device Pascal (Edwards Lifesciences) and Cardioband using transseptal approach, and also NeoChord and Harpoon using transapical approach.