Mitral valve interventions in heart failure.

PURPOSE OF REVIEW: This review describes new developments in mitral valve interventions for patients with heart failure. The review also discusses innovative therapies in the treatment of mitral regurgitation in patients with heart failure and describes novel risk factors of recurrent mitral regurgitation following repair in this population. RECENT FINDINGS: Percutaneous strategies are rapidly emerging as an important adjunct to conventional mitral surgery, specially for patients with functional mitral regurgitation and heart failure. Percutaneous therapies are a well-tolerated alternative to surgery in high-risk patients, but their long-term efficacy is not established. Partial ring annuloplasty and preoperative galectin-3 levels may be associated with recurrent mitral regurgitation after repair. Preclinical work has focused on injectable substances, which may ameliorate adverse left ventricular remodeling and recurrent mitral regurgitation after surgery. SUMMARY: Percutaneous therapies will continue to evolve and serve as an alternative to conventional surgery for patients with mitral regurgitation and heart failure. Determining anatomic and biochemical risk factors associated with recurrent mitral regurgitation after repair is crucial in tailoring therapy to individual patients. Preclinical work regarding infarct stabilization may benefit future patients with heart failure.