Ischemic Mitral Regurgitation

Valvular involvement in coronary artery disease is an important prognostic factor for cardiac-related mortality. In the past decade, transcatheter edge-to-edge repair (TEER) using the MitraClip (Abbott Vascular, Menlo Park, CA, USA) has emerged as a less-invasive treatment option for patients with severe mitral regurgitation (MR) and a reduced ejection fraction. A recent major trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation [COAPT trial]) investigating this treatment revealed a significant impact in patients with functional MR, a population in which two-thirds have ischemic etiology. This review highlights the mechanism underlying ischemic MR along with a comparison with the surgical interventions and describes the current usage, clinical implications, and future perspectives of TEER using the MitraClip in this patient population.