The multidisciplinary Heart Team in mitral valve transcatheter edge-to-edge repair.

Abstract

Treatment options for mitral regurgitation (MR) have markedly evolved over the past few decades, with mitral valve transcatheter edge-to-edge repair (M-TEER) expanding the clinical armamentarium of guideline-directed medical therapy and surgical techniques. However, the variety of mitral valve anatomies, the presence of heart failure (HF), and consideration of the individual patient risk require a multidisciplinary Heart Team approach to identify the optimal treatment for MR for each patient. Despite the growing field of transcatheter mitral interventions and the longstanding availability of surgical mitral valve repair and replacement, evidence from randomized clinical trials comparing intervention with surgery remains scarce. In the meantime, the increasing safety and experience of surgical and interventional procedures have shifted the perspective on mitral valve disease in terms of when and how to treat it. Therefore, the multidisciplinary Heart Team discussion has become of paramount importance in the evaluation and treatment decisions for patients with mitral valve disease.