Mitral regurgitation (MR) is a common valvular heart diseasewhose prevalence continues to increase with population aging, posing a serious threat to human health in the advanced stages of the disease. Sole reliance on medication and traditional surgical treatments can no longer meet the therapeutic needs of all patients. Transcatheter interventional therapy is gradually emerging as a promising new treatment option. Recently, technologies for the transcatheter interventional treatment of MR have advanced rapidly, with expanding indications and a continuous stream of new devices. The field has entered a phase of accelerated development in the treatment of structural heart disease, demonstrating broad clinical prospects. This article reviews the key technologies and developmental trends in the current transcatheter interventional treatments for MR, aiming to provide a theoretical basis and rationale for the safe and standardized implementation and broader adoption of these technologies.

Mitral regurgitation (MR) is a prevalent and prognostically relevant valvular disease, especially in patients with heart failure, in whom MR contributes to adverse remodeling, increased symptom burden, and higher mortality. Surgical repair or replacement remains the standard of care for suitable candidates, but many patients are excluded because of advanced age, comorbidities, or high surgical risk. Transcatheter methods have emerged as transformative alternatives, including mitral transcatheter edge-to-edge repair (MTEER) with devices such as MitraClip and PASCAL, annuloplasty-based devices such as Carillon and Cardioband, and transcatheter mitral valve replacement (TMVR) with devices such as Tendyne, Intrepid, and others under development. Data from randomized trials and registries have established that MTEER lowers hospital readmission rates and improves mortality in carefully selected secondary MR subjects, and that device upgrades improve procedural success and anatomical versatility. Annuloplasty provides targeted repair for functional MR with annular dilation, whereas TMVR offers an alternative for anatomically complex cases or those ineligible for MTEER, albeit with distinct procedural risks. Management of severe mitral annular calcification remains difficult and demands meticulous pre-procedural planning and customized device strategies. Careful patient selection based on MR etiology, proportionality, ventricular function, and anatomical suitability is essential for optimizing outcomes in this rapidly evolving field.

We present a fully coupled, patient-specific 3D-0D computational framework for hearts supported with left ventricular assist devices (LVAD) that enables controlled in silico experimentation. The approach monolithically integrates three-dimensional CFD of the left ventricle (LV), left atrium (LA), aortic root, and LVAD cannulae with a closed-loop 0D lumped parameter network of the full circulation. Mitral and aortic valve dynamics are governed by transvalvular pressure and flow with patient-specific regurgitant orifice areas, and the LVAD is represented via a pressure-flow (H-Q) relation. This manuscript provides the complete mathematical formulation, coupling strategy, and parameterization required to build a reproducible pipeline from dynamic CT, 2D transthoracic echocardiography, and right heart catheterization. This methodology is demonstrated in a patient under long-term support of LVAD and concomitant mitral and aortic regurgitation. The personalized, fully coupled 3D-0D models reproduced available clinical targets with a mean error of 8.6%, enabling controlled in silico interrogation of valve repair strategies. In the patient-specific state, simulated mitral and aortic regurgitant volumes were 6.6 and 6.5 mL per cycle, yielding a forward cardiac output of 3.16 L/min despite an LVAD flow of 3.7 L/min. In silico isolated mitral valve (MV) repair, isolated aortic valve (AV) repair, and combined MV+AV repair increased forward output to 3.41, 3.33, and 3.55 L/min, respectively; however, aortic valve opening and increased aortic pressure pulsatility (up to 38.9 vs. 13.5 mmHg) were observed only when MV repair was involved. These left-sided improvements propagated through the cardiopulmonary circulation, reducing pulmonary pressures and right ventricular loading, with the largest benefit observed following combined repair. We show that the modeling platform presented provides a powerful means to study mechanical circulatory support, enabling patient-specific evaluation of surgical interventions in patients with LVAD and delivering quantitative insight into clinically important metrics-such as aortic pulsatility, RV afterload, and chamber-level flow patterns.