Over the last decade, multiple transcatheter mitral valve repair and replacement strategies have emerged, yet there is only 1 US Food and Drug Administration approved device, the MitraClip (Abbott Vascular, Inc., Santa Clara, CA). Current guidelines support the use of the MitraClip in high or prohibitive surgical risk patients, but there are many patients that are not anatomically suited for the device. This review article discusses the approach to degenerative and functional mitral regurgitation in the high-prohibitive risk patient, how to choose transcatheter treatment options (both approved and investigational), and potential management for therapy failure.

在过去的十年中，出现了多种经导管二尖瓣修复和置换策略，但只有 1 个美国食品和药物管理局批准的设备，即 MitraClip（雅培血管公司，加利福尼亚州圣克拉拉）。目前的指南支持在高风险或手术风险过高的患者中使用 MitraClip，但有许多患者在解剖学上不适合该设备。这篇综述文章讨论了高禁忌风险患者退行性和功能性二尖瓣反流的治疗方法、如何选择经导管治疗方案（已批准的和正在研究的）以及治疗失败的潜在管理方法。