Transcatheter direct mitral valve annuloplasty: a brief review.

Research and development of percutaneous therapy for mitral regurgitation (MR) began over a decade ago with concepts based on coronary sinus annuloplasty which had the potential to mimic established surgical procedures. While at the present time leaflet repair with the MitraClip has become the most frequently used device approach, several devices that accomplish direct annuloplasty have recently made important advances. Still in their early stages, three direct annuloplasty devices have been used in early human clinical experience, and other methods have been tested in preclinical models. As annuloplasty itself has been the mainstay of surgery for functional MR (FMR) for decades, the prospect of transcatheter direct annuloplasty is, by its nature, more attractive and the devices involved more closely mimic surgery. As these procedures and devices are still evolving, their future role needs to be further defined and established.