State of the Art: Transcatheter Edge-to-Edge Repair for Complex Mitral Regurgitation

Nir Flint, Matthew J. Price, Stephen H. Little, G. Burkhard Mackensen, Nina C. Wunderlich, Moody Makar, Robert J. Siegel

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Transcatheter edge-to-edge mitral valve repair has revolutionized the treatment of primary and secondary mitral regurgitation. The landmark EVEREST (Endovascular Valve Edge-to-Edge Repair Study) and COAPT (Clinical Outcomes Assessment of the MitraClip Percutaneous Therapy for High Surgical Risk Patients) trials included only clinically stable patients with favorable mitral valve anatomy for edge-to-edge repair. However, since its initial commercial approval in the United States, growing operator experience, device iterations, and improvements in intraprocedural imaging have led to an expansion in the use of transcatheter edge-to-edge repair to more complex mitral valve pathologies and clinical scenarios, many of which were previously considered contraindications for the procedure. Because patients with prohibitive surgical risk are often older and present with complex mitral valve disease, knowledge of the potential effectiveness, versatility, and technical approach to a broad range of anatomy is clinically relevant. In this review the authors examine the current experience with mitral valve transcatheter edge-to-edge repair in various pathologies and scenarios that go well beyond the EVEREST II trial inclusion criteria.

Original languageEnglish (US)
Pages (from-to)1025-1037
Number of pages13
JournalJournal of the American Society of Echocardiography
Issue number10
StateAccepted/In press - 2021


  • EVEREST trial
  • MitraClip
  • Mitral regurgitation
  • Mitral valve repair
  • Percutaneous mitral edge-to-edge repair

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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