LAUSR

Mitral valve regurgitation (MR) affects nearly 10% of adults over the age of 75 and is the leading cause of valvular disease in Western countries. 1 Although surgical repair or replacement remains the standard of care for patients with severe, symptomatic MR, nearly one ‐ half of patients are not referred for surgery. 2 Given a 5 ‐ year mortality rate of nearly 50% in this high ‐ risk population, new less ‐ invasive technologies are being developed as an alternative approach to surgical intervention. With the success and worldwide adoption of transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair (TMVR) in particular has emerged as a potential therapeutic option. 2 However, the inherent technical risk, durability of prosthetic valves, and pathophysiologic differences betweenTAVR and TMVR have slowed the adoption of transcutaneous mitral valve (MV) intervention. It was not until 2017 — nearly 6 years after the first TAVR indication approval with the Edwards Sapien 3 valve — that the US Food and Drug Administration approved TMVR. Because the technology is rapidly developing, it is imperative to identify the pitfalls encountered in treating different groups of patients and to better council and risk ‐ stratify at ‐ risk populations.