Transcatheter Mitral and Tricuspid Valve Therapies

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Editorial

04 December 2023

Editorial: Transcatheter mitral and tricuspid valve therapies

Omar Chehab

,

Ronak Rajani

,

Simon Redwood

,

Bernard Prendergast

and

Tiffany Patterson

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Editors

3

Tiffany Patterson

King's College London

Omar Chehab

St Thomas' Hospital

Bernard Prendergast

Guy's and St Thomas' NHS Foundation Trust

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About

Transcatheter valve therapies have emerged as a viable treatments option for patients deemed high risk for conventional surgery. Whilst transcatheter aortic valve implantation (TAVI) is now established as the standard of care in high-risk aortic stenosis patients, the mitral and tricuspid frontiers have proved to be more challenging. Anatomical heterogeneity, device development, refining patient selection and until recently the absence of randomised data have all been contributing factors. For mitral regurgitation, transcatheter edge to edge repair (TEER) now benefits from positive randomised data along with significant advancements in device technology. Transcatheter mitral valve replacement (TMVR) options are also making rapid progress. More recently, tricuspid regurgitation has become the central focus of the structural heart community having previously been referred to as the “forgotten valve”.

Primary MR: A significant proportion of patients do not derive symptomatic benefit or reverse remodel following TEER. Selecting the right patient for the right intervention to maximise benefit and potential for a durable result is vital. The objective is to discuss how much MR reduction is optimal and whether the threshold for “procedural success” needs to be redefined.

Secondary MR: There are numerous theories as to which patients benefit from TEER given the discrepant MITRA FR and COAPT results. Is there one prevailing theory/narrative that appears to identify favourable responders?

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Editors

Tiffany Patterson

King's College London

Omar Chehab

St Thomas' Hospital

Bernard Prendergast

Guy's and St Thomas' NHS Foundation Trust

Impact

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Published In

Frontiers in Cardiovascular Medicine

Heart Valve Disease, Structural Interventional Cardiology

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