Identifying Responders to Transcatheter Interventions for Secondary Mitral Regurgitation

This article offers a comprehensive review of the literature on imaging predictors of response to transcatheter interventions for secondary mitral regurgitation (SMR). Recent advancements in percutaneous valve therapies have broadened treatment options for high-risk patients with SMR. While recent studies have demonstrated significant reduction in all-cause mortality and hospitalizations with transcatheter edge-to-edge repair (TEER), significant controversy remains. This review highlights the central role of multi-modality imaging to guide therapeutic decision making for optimal treatment response and long-term outcomes. Several echocardiographic, computerized tomography (CT) and cardiac magnetic resonance (CMR) imaging parameters are central to identifying optimal conditions for transcatheter therapies. Imaging features have become key predictors of outcomes following transcatheter interventions for secondary mitral regurgitation and provide important risk stratification to guide therapeutic decision making and shared decision making.