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Mitral regurgitation (MR) is the most prevalent form of valve disease in developed countries1 and its prevalence increases with age affecting ~10% of people > 75 years.2MR is a very heterogenous disease that damages not only the mitral valve apparatus but also its surrounding structures. In primary MR, mitral valve surgery is the therapy of choice in symptomatic patients or asymptomatic patients with left ventricular dysfunction. Surgical repair is generally preferred over replacement if technically feasible.3,4 In secondary MR, the surgical approach is still under discussion5 and it is spared for patients with indications for other surgical cardiac procedures (ie, coronary artery bypass graft).3,4 Several studies suggest that a large proportion of MR patients are never treated due their high surgical risk6 and that such a conservative approach results in high re-hospitalization (~90%) and mortality rates (50%) within 5 years following the initial diagnosis.7This population has become a clear unmet need and a target for the development of less invasive therapeutic approaches. Several transcatheter mitral valve repair (TMVR) technologies inspired by well-established surgical techniques have been developed and have already been approved for clinical use. The most commonly used, the MitraClip device (Abbott Vascular, United States) has reached more than 100...