# Diagnosis and Diagnostic Challenges of Secondary Mitral Regurgitation in the Era of Transcatheter Edge-to-Edge Repair of the Mitral Valve

## TL;DR

This paper discusses the diagnosis and treatment of secondary mitral regurgitation, focusing on recent advances in transcatheter repair and the importance of patient selection.

## Contribution

The paper provides a comprehensive review of the diagnosis and management of secondary mitral regurgitation in the context of m-TEER advancements.

## Key findings

- Three distinct forms of secondary mitral regurgitation have been identified.
- Transcatheter edge-to-edge repair has revolutionized treatment options for sMR.
- Accurate diagnosis and patient selection are crucial for successful m-TEER outcomes.

## Abstract

Secondary mitral regurgitation (sMR) is commonly understood to be secondary to heart failure (HF), left ventricular (LV) dilation, and altered coaptation of the mitral annulus. Three forms of sMR exist: non-ischemic sMR, ischemic sMR, and atrial functional sMR. In the past, there have been limited treatment options for this condition besides medication. Recently, the management of sMR has been revolutionized by the recent advances in percutaneous transcatheter edge-to-edge repair of the mitral valve (m-TEER). However, the major trials investigating this technology have shown that appropriate patient selection is of critical importance to achieve benefit. As such, there is a renewed interest in the accurate diagnosis of sMR. Herein, we review the etiology, management, and diagnosis of sMR in the era m-TEER.