Evolving concepts and technologies in mitral valve repair

Mitral valve repair has matured and moved beyond the first generation of techniques and devices. We have a better understanding of the pathophysiology and limitations of prior approaches. New techniques and rings have been designed to increase the effectiveness and durability of mitral valve repair, and it is hoped that these advances will translate into more widespread adoption of these techniques by surgeons. Percutaneous approaches to mitral valve repair are in their infancy, much as mitral valve repair itself was in the 1970s. An appreciation of the lessons learned from surgical mitral valve repair will aid in the development of novel percutaneous repair approaches that are safe, effective, and durable.