Why is this study important?  

• Proof of concept of new technique for direct reduction in mitral valve annular area. 
• Identified a potential new adjunctive therapy to current TEER procedures. 

 
What question was this study supposed to answer? 

• Previous attempts at annular reduction using the coronary sinus have been disappointing. 
• This study demonstrated the technical feasibility of intramyocardial device delivery. 

 
What did the study show? 

• Procedural success in a small group (n=19) of HFpEF and HFrEF patients with persistent MR after TEER. 
• The ability to evaluate the procedural success and potential complications and stop the procedure without complications. 
• Improvement in both physiologic parameters and clinical functional status. 

All authors: Steven R. Bailey, MD, MSCAI