Abstract

Functional Mitral Regurgitation (MR), due to incomplete mitral leaflet closure rather than an inherent abnormality in the valve apparatus, is a highly prevalent condition that is associated with an adverse prognosis in patients with heart failure. To date, traditional medical therapies have largely been ineffective, and enthusiasm for various surgical strategies has been limited by their lack of prognostic benefit and perceived high risk. In order to overcome some of these issues, a number of percutaneous approaches have recently emerged, and while these techniques are still in the research arena, there is already encouraging early data. This chapter will address the pathophysiologal mechanisms involved in functional MR, and summarise the current data available on percutaneous mitral valve therapies, with a particular emphasis on devices involving ‘indirect annuloplasty’ via the coronary sinus.