Mitral valve interventions are the next frontier for the structural heart interventionalist. Several challenges have to be overcome, including the variability of mitral valve disease and anatomy, the need for advanced imaging and the need for multiple devices, potentially to be used in combination. However, the unmet need for less-invasive treatments for mitral valve insufficiency is a great driver to innovate in this field. Technologies to treat mitral valve regurgitation include repair devices acting at the leaflet, annular or subannular level, as well as replacement devices. Early experience with the MitraClip (Abbott Vascular Inc., CA, USA) device is very promising: the therapy is applicable to mitral regurgitation with different etiologies with safe and durable results. More devices will enter clinical practice in the next few years to expand indications and to improve outcomes. 2012 Future Medicine Ltd.
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