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Severe mitral regurgitation (MR) is associated with heart failure and impaired survival with an annual mortality risk in excess of 5% per year for unoperated patients. Despite availability of surgical mitral valve interventions, as many as half of all patients with severe MR do not receive interventions. Transcatheter edge-to-edge repair with MitraClip has been a revolutionary therapy for MR, with over 100,000 treated patients worldwide. The usage has also expanded to different challenging anatomies as well as tricuspid regurgitation. Additionally, other transcatheter edge-to-edge repair devices are being studied. The evolution of these devices as well as what to expect in the future will be discussed here.

Edge-to-edge repair: past challenge, current case selection and future advances