Transcatheter Mitral Valve Replacement

Transcatheter Mitral Valve Replacement (TMVR) is an emerging minimally invasive procedure designed to treat patients with severe mitral valve disease, particularly mitral regurgitation (MR) or mitral stenosis, who are considered too high-risk for traditional open-heart surgery. In mitral regurgitation, the valve between the left atrium and left ventricle doesn’t close properly, allowing blood to flow backward into the atrium, leading to symptoms like shortness of breath, fatigue, and heart failure. TMVR provides an alternative for patients who may not be able to undergo surgical mitral valve repair or replacement due to advanced age or other medical conditions.

The TMVR procedure involves inserting a new valve through a catheter, typically through a vein in the leg (transfemoral approach), though other access points, such as the chest (transapical), can also be used. The catheter is guided to the heart and positioned within the faulty mitral valve. Once the new valve is in place, it expands and takes over the function of the native valve, ensuring one-way blood flow between the heart’s chambers. TMVR can be performed under local or general anesthesia, and it significantly reduces recovery time compared to open-heart surgery.

Though still relatively new compared to procedures like Transcatheter Aortic Valve Replacement (TAVR), TMVR is a promising option for high-risk patients with mitral valve disease. Clinical trials have demonstrated the procedure’s ability to improve symptoms and reduce hospital readmissions for heart failure. However, it is technically more challenging than TAVR due to the complex anatomy of the mitral valve, which requires careful patient selection and precise procedural execution to avoid complications such as valve leakage or blood clot formation.