Percutaneous Transcatheter Edge-to-Edge Mitral Valve Repair With MitraClip System in the Era of G4

The use of transcatheter edge-to-edge mitral valve repair (TEER) in symptomatic patients with severe mitral regurgitation (MR) has dramatically increased over the last few years. Current guidelines consider TEER as a reasonable option in symptomatic patients with primary or chronic secondary severe MR with high or pro-hibitive surgical risk and favorable anatomy. However, several anatomical and morphological mitral features have restricted the use of this mini-invasive technique in its early experience. The latest fourth generation (G4) of the MitraClip system has been recently introduced and includes the possibility of independent leaflet grasping and 4 different sizes. This technical update offers the possibility of selecting and combining multiple devices for complex mitral valve anatomies and challenging procedures, which helps expand the applications of TEER. The present review describes the potential advantages and the help of the MitraClip G4 devices to overcome various anatomic and morphologic issues in challenging cases with complex primary and secondary MR procedures.

Automated summary

The use of transcatheter edge-to-edge mitral valve repair (TEER) has significantly increased in symptomatic patients with severe mitral regurgitation (MR) in recent years. Current guidelines recommend TEER as a viable option for patients with primary or chronic secondary severe MR and high or prohibitive surgical risk. However, anatomical and morphological limitations of the mitral valve have initially restricted the use of this mini-invasive technique. The introduction of the latest fourth generation (G4) MitraClip system has overcome these limitations and expanded the applications of TEER.