Transcatheter Mitral Valve Replacement

Mitral regurgitation (MR) is a leading cause of valvular heart disease, but up to half of patients with moderate to severe MR are not referred for conventional mitral valve surgery due to advanced age or multiple comorbidities. Transcatheter mitral valve implantation (TMVI) is an emerging alternative technology, and the only evice with a “Conformite Europeenne” mark and the largest successful experience to date is the Tendyne TMVI device, designed specifically for placement in the native mitral annulus. This chapter reviews the development of the Tendyne TMVI system, preprocedural planning and selection criteria, implantation technique, periprocedural and early clinical outcome, and long-term follow-up and durability. Successful deployment results in complete relief of mitral regurgitation in most cases, with instantaneous and sustained improvements in cardiac physiology and significant immediate and longer-term symptomatic improvement.