Percutaneous Mitral Valve Procedures

As the population ages, more patients are presenting with symptomatic mitral valve disease that requires risk-prohibitive cardiac surgery. In the last decade, advances in valve technology have generated valves that can be inserted via a minimally invasive percutaneous approach. Nonetheless, patients must fulfill specific criteria in order to be considered for a percutaneous mitral intervention. From an anesthesiologist’s perspective, these cases are unique as they require both a detailed understanding of complex patient physiology and the need to be planned as fast-track procedures. Echocardiography is the cornerstone to success for these procedures, and typically a separate team of echocardiographers may be involved in the conduct of the case. This review discusses patient selection, complications of the procedure, and perioperative considerations for this technique.