Secondary Mitral Regurgitation: What to Achieve with Intervention and Surgery

Secondary mitral regurgitation (MR) is common and of adverse prognostic effect in patients suffering from congestive heart failure. Until now there is no conclusive evidence for a survival benefit after mitral valve intervention and optimal medical therapy (including cardiac resynchronization therapy if indicated) is the cornerstone of treatment. Recommendations on therapy of secondary mitral valve regurgitation are therefore, also in the recently published ESC guidelines, based only on expert opinion. Percutaneous edge-to-edge repair with the MitraClip is a low-risk alternative to surgery resulting in symptomatic relief in patients who are not at low risk and who have no option for revascularization.