• Approximates the anterior and posterior leaflets of the MV at the origin of the MR jet, creating a double-orifice MV that is similar to the surgical Alfieri stitch
  • Echo features that portend benefit from mTEER include:
    • LVEF 20-50%,
    • LV end-systolic dimension <70 mm, and
    • PASP <70 mm Hg
  • Who will you recommend for a MitraClip?
    • Severe, symptomatic primary MR with prohibitive risk of cardiac surgery (STS-Predicted Risk of Mortality ≥ 8% or high-risk characteristics) as assessed by a cardiac surgeon
    • Severe, symptomatic secondary MR on maximally tolerated GDMT
      • if MR severity and LV parameters are consistent with COAPT trial criteria