Transcatheter Mitral Valve Replacement with the CardiAQ‐Edwards and EVOQUE Prostheses

The goal of transcatheter mitral valve replacement (TMVR) for mitral regurgitation is to avoid the risks of more invasive surgical approaches, including those associated with the use of sternotomy and cardiopulmonary bypass, while preserving equivalent or better outcomes. This chapter describes the historical development, initial results, current status, and future directions of the CardiAQ-Edwards and EVOQUE TMVR systems. The initial experience with CardiAQ TMVR reflected many of the challenges typical in this field, including the initial inclusion of compassionately treated high-risk subjects with multiple comorbidities, who were predominantly treated with a relatively invasive transapical approach. Use of the CardiAQ-Edwards and EVOQUE TMVR systems as well as others will require complex decision-making on an individual patient level incorporating patient age, frailty, comorbidities, goals of care (including patient preferences), specific valve anatomy, and safety and efficacy of each device.