Purpose of review

Transcatheter mitral valve replacement (TMVR) has been developed to address the need for an alternative therapeutic option to surgery in patients suffering from severe mitral regurgitation who are at high surgical risk. The present review illustrated the state-of-the-art of catheter-based mitral valve replacement evaluating technical characteristics and early clinical experience of different devices to outline prospects and challenges of TMVR.

Recent findings

Several devices are currently under clinical assessment. Early experience has demonstrated high procedural success of TMVR. However, TMVR faces several possible hurdles such as left ventricular outflow tract obstruction (LVOTO) after prosthesis deployment, access site complications, and thrombotic risk requiring anticoagulatory therapy.

Summary

Future studies should assess long-term prosthesis stability, optimal anticoagulation regime, and occurrence of paravalvular leakage. The development of smaller TMVR prostheses suitable for transseptal implantation could overcome bleeding complications. In perspective, TMVR may emerge to a clinically relevant therapeutic approach for patients with severe MR at high surgical risk.

中文翻译：

---

导管二尖瓣置换术的现状

 审查目的

经导管二尖瓣置换术 (TMVR) 的开发是为了满足手术风险较高的严重二尖瓣反流患者对手术替代治疗方案的需求。本综述阐述了基于导管的二尖瓣置换术的最新技术，评估了不同设备的技术特征和早期临床经验，概述了 TMVR 的前景和挑战。

 最近的发现

目前有几种设备正在接受临床评估。早期经验表明 TMVR 程序非常成功。然而，TMVR 面临着几个可能的障碍，例如假体部署后的左心室流出道梗阻 (LVOTO)、进入部位并发症以及需要抗凝治疗的血栓形成风险。

 概括

未来的研究应评估长期假体稳定性、最佳抗凝方案以及瓣周漏的发生。开发适合经房间隔植入的较小 TMVR 假体可以克服出血并发症。从长远来看，TMVR 可能成为手术风险高的严重 MR 患者的临床相关治疗方法。