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Transcatheter Mitral Valve Therapy: Opportunities And Challenges

Amid the clinical and commercial success of transcatheter aortic valve replacement (TAVR), companies are preparing for what is predicted to be an even larger market in minimally invasive mitral valve replacement and repair technologies; in the summer of 2015, strategics made huge bets in quick succession on promising replacement valves. There is a great deal of activity on the repair side, too, and debate is ongoing about technical and regulatory challenges and which technologies are likely to be appropriate for patients with various types of mitral valve regurgitation.

How do you solve a problem like mitral regurgitation (MR)? MR afflicts over 4 million people in the US alone. Many of those with worse disease have no good treatment options, while for others, the gold standard is open-heart surgery. As transcatheter aortic valve replacement (TAVR, sometimes called transcatheter aortic valve implantation, or TAVI) has taken off, strategics and investors aware of the massive unmet need in MR are looking to this space as the next big thing in minimally invasive structural heart intervention. (See[A#2015700019].)

Market-size estimates for transcatheter mitral valve replacement/repair (TMVR) vary widely, with a common guess that it will be three to four times the size of the TAVR market. One estimate...

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