Using imaging to guide patient selection and performance of catheter-based mitral valve repair for mitral regurgitation.

Percutaneous transcatheter therapies for mitral regurgitation have found a role for patients at high operative risk with both degenerative and functional pathologies. The MitraClip therapy utilizes a catheter-based system to deliver a clip-type implant to provide apposition between anterior and posterior mitral leaflets. Key to the procedure is using imaging to guide patient selection as well as intra-procedure performance. Careful patient selection remains paramount for success with the MitraClip, with imaging determination of appropriate mitral pathology. Technical success is dependent on skill with echocardiographic imaging, with three-dimensional transesophageal echocardiography particularly valuable.