Transcatheter Mitral Valve Repair (TMVR) has emerged as a transformative therapy for patients with symptomatic mitral regurgitation who are unsuitable for conventional surgery. As device innovations expand and imaging technology advances, clinicians increasingly seek updated insights on TMVR when attending interventional and structural-heart pathways at a cardiology conference. With multiple repair strategies—including edge-to-edge repair, chordal replacement, annuloplasty and investigational mitral-replacement systems—TMVR continues to reshape the field of percutaneous mitral interventions.

The session begins by reviewing the pathophysiology of primary and secondary mitral regurgitation, explaining how leaflet abnormalities, annular dilation, ventricular remodeling and ischemic dysfunction influence treatment selection. Participants explore patient-evaluation frameworks incorporating anatomical classification, regurgitation severity, ventricular function, comorbidity assessment and the Heart Team decision model.

Technical aspects of TMVR are discussed in depth. Attendees examine imaging modalities such as 3D TEE, fluoroscopy and CT for procedural planning, emphasising leaflet morphology, coaptation gaps, annular geometry and calcification patterns. Detailed procedural walkthroughs illustrate transseptal puncture, device navigation, leaflet capture, clip deployment and post-repair assessment. Participants also learn when TMVR is preferred over surgical repair or transcatheter replacement.

The session highlights potential complications including leaflet detachment, single-leaflet device attachment, residual regurgitation, stenosis, tamponade and vascular complications. Strategies for prevention, early detection and management are reviewed, emphasising the value of standardised imaging, procedural precision and real-time team communication.

Long-term outcomes, durability considerations and post-procedure monitoring are addressed with guidance on antithrombotic therapy, heart-failure optimisation and surveillance imaging. Attendees explore TMVR in challenging anatomies—functional MR, prior surgical rings, radiation-induced valve disease and frail populations—and learn practical approaches for difficult cases.

Future innovations are discussed, including transcatheter mitral-replacement platforms, advanced leaflet-repair devices, fusion imaging, robotics and AI-driven procedural planning. By incorporating structural interventions, imaging advances and multidisciplinary decision-making, clinicians leave with a comprehensive understanding of modern TMVR care.