Consensus Document on Non-Suitability for Transcatheter Mitral Valve Repair by Edge-to-Edge Therapy

As transcatheter therapies for mitral valve repair and replacement have increased, there exists a lack of clarity as to which patient and anatomic factors should determine patient selection for transcatheter repair versus replacement. At the request of the US Food & Drug Administration and under the auspices of the Heart Valve Collaboratory, a multi-disciplinary group convened to create this expert opinion document to identify patient and valvular factors that define non-suitability for transcatheter edge to edge repair, including 1) anatomic issues leading to the development of mitral stenosis, 2) anatomic factors associated with inadequate reduction in mitral regurgitation, 3) patient factors associated with inability to perform the TEER, and 4) clinical factors associated with futility in performing TEER. In such patients, barring futility, transcatheter mitral replacement could be considered.