Jozef Pacák
Mitral regurgitation (MR) is the second most frequent valvular heart disease in western countries. It can be of organic (rheumatic, prolapse syndrome, after-inflammatory due to mitral endocarditis) or functional origin (ischemic, left ventricular failure of any cause). European heart disease survey on valvular diseases has shown that up to one half of patients with severe symptomatic MR have not been referred for surgery (mitral valve repair or replacement). The main reason was the impaired left ventricular function, old age and comorbidities. In this context, the percutaneous transcatheter repair brings a promising approach for these selected, high-risk patients. The paper tries to describe new emerged technologies for minimally invasive transcatheter devices. They are targeting the left heart structures such as: mitral leaflets, annulus, chordae tendinae, left ventricle itself, and left atrium. The paper also mentions percutaneous mitral valve-in-valve replacement. The MitraClip® device (Abbot Vascular) has achieved non-inferiority to open heart surgery in the randomized clinical trial (EVEREST II) in the selected group of patients. Various technologies are at different stages of experimental and clinical investigations. Some of approaches are very promising and there is an assumption that combination of the techniques can bring alleviation of the symptoms, improve the prognosis and bring a hope for those sick patients.