Transcatheter Treatment of Functional Mitral Regurgitation in Patients with Heart Failure

Secondary (functional) mitral regurgitation is strongly associated with recurrent heart failure (HF) hospitalizations, poor quality of life, and high rates of mortality. The COAPT trial demonstrated that transcatheter edge-to-edge mitral leaflet repair with the MitraClip device led to a decrease in the severity of secondary mitral regurgitation, a significantly lower rate of hospitalization for heart failure, lower mortality, and better quality of life and functional capacity within 24 months of follow-up compared with medical therapy alone. In this article, the authors review the COAPT trial rationale, design, results, and their clinical implications.