Percutaneous Repair of Secondary Mitral Regurgitation — A Tale of Two Trials

The mitral valve is a complex structure encompassing the valve leaflets, annulus, chordae tendineae, and papillary muscles.1 Primary mitral regurgitation is caused by a primary leaflet abnormality, whereas secondary mitral regurgitation occurs when structurally normal valve leaflets are unable to coapt completely owing to distortion of the supporting apparatus resulting from an ischemic or dilated cardiomyopathy. Current guidelines recommend early surgery for severe primary mitral regurgitation,2,3 but the management of secondary mitral regurgitation, which is essentially a disease of the left ventricle, is more controversial. Patients who have left ventricular dysfunction and secondary mitral regurgitation of any severity have a . . .