Percutaneous intervention for mitral valve (MV) disease has been established as an alternative to open surgical MV repair in patients with prohibitive surgical risk. Multiple percutaneous approaches have been described and are in various stages of development. Edge-to-edge leaflet plication with the MitraClip (Abbott, Menlo Park, CA) is currently the only Food and Drug Administration-approved device specifically for primary or degenerative lesions. Use of the edge-to-edge clip for secondary mitral regurgitation is currently under investigation and may result in expanded indications. Echocardiography has significantly increased our understanding of the anatomy of the MV and provided us with the ability to classify and quantify the associated mitral regurgitation. For percutaneous interventions of the MV, transesophageal echocardiography imaging is used for patient screening, intraprocedural guidance, and confirmation of the result. Optimal outcomes require the echocardiographer and the proceduralist to have a thorough understanding of intra-atrial septal and MV anatomy, as well as an appreciation for the key points and potential pitfalls of each of the procedural steps. With increasing experience, more complex valvular pathology can be successfully percutaneously treated. In addition to two-dimensional echocardiography, advances in three-dimensional echocardiography and fusion imaging will continue to support the refinement of current technologies, the expansion of clinical applications, and the development of novel devices.

二尖瓣（MV）疾病的经皮介入治疗已被确定为手术风险高的患者的开放式手术MV修复的替代方法。已经描述了多种经皮方法，并且它们处于发展的各个阶段。使用MitraClip（加利福尼亚州门洛帕克市，阿伯特市）进行的边到边小叶折叠术是目前唯一获得美国食品和药物管理局批准的专用于原发性或退行性病变的器械。目前正在研究使用边缘到边缘的夹子进行继发性二尖瓣反流，并可能导致适应症扩大。超声心动图显着增加了我们对MV解剖结构的了解，并为我们提供了对相关二尖瓣关闭不全进行分类和量化的能力。对于MV的经皮干预，经食道超声心动图成像用于患者筛查，术中指导和结果确认。最佳结果要求超声心动图医师和程序医师对房间隔和MV解剖结构有透彻的了解，并对每个程序步骤的要点和潜在陷阱有所了解。随着经验的增加，可以成功地经皮治疗更复杂的瓣膜病变。除了二维超声心动图，三维超声心动图和融合成像技术的进步将继续支持当前技术的完善，临床应用的扩展以及新型设备的开发。最佳结果要求超声心动图医师和程序医师对房间隔和MV解剖结构有透彻的了解，并对每个程序步骤的要点和潜在陷阱有所了解。随着经验的增加，可以成功地经皮治疗更复杂的瓣膜病变。除了二维超声心动图，三维超声心动图和融合成像技术的进步将继续支持当前技术的完善，临床应用的扩展以及新型设备的开发。最佳结果要求超声心动图医师和程序医师对房间隔和MV解剖结构有透彻的了解，并对每个程序步骤的要点和潜在陷阱有所了解。随着经验的增加，可以成功地经皮治疗更复杂的瓣膜病变。除了二维超声心动图，三维超声心动图和融合成像技术的进步将继续支持当前技术的完善，临床应用的扩展以及新型设备的开发。更复杂的瓣膜病理可以成功地经皮治疗。除了二维超声心动图，三维超声心动图和融合成像技术的进步将继续支持当前技术的完善，临床应用的扩展以及新型设备的开发。更复杂的瓣膜病理可以成功地经皮治疗。除了二维超声心动图，三维超声心动图和融合成像技术的进步将继续支持当前技术的完善，临床应用的扩展以及新型设备的开发。