Coronary Sinus and Direct Annuloplasty Approaches for Percutaneous Mitral Valve Repair

M itral regurgitation (MR) is today the second most frequent native valve disease in Western countries after aortic stenosis, which justifies the interest in its treatment. Mitral valve surgery, especially valve repair, is the gold standard for treatment of patients with severe symptomatic MR and/or objective signs of left ventricular dysfunction. However, surgery may be high risk or even contraindicated in a substantial group of patients due to the presence of severe comorbidities and/or very severe left ventricular dysfunction. These findings set the stage for the new percutaneous techniques.