Session 1.4 | Mitral Session

Chair: Nicolas Van Mieghem

Panel: Andrea Scotti; David Daniels; Neil Fam; Mark Russo; Vratika Agarwal

The mitral valve landscape is evolving rapidly and this session brings the full spectrum into focus. Dr Vratika Agarwal opens with a practical anatomical framework for decision-making, guiding operators through the green, yellow and red zones that determine repair versus replacement strategy. Dr David Daniels then demonstrates a technically demanding Transcatheter Mitral Valve Replacement (TMVR) case in an 82-year-old with prior MitraClip, severe Mitral Annular Calcification (MAC), and high Left Ventricular Outflow Tract (LVOT) obstruction risk, navigating SESAME septal modification and M3 deployment with the clips left in situ. Dr Andrea Scotti delivers a step-by-step Transcatheter Edge-to-Edge Repair (TEER) walkthrough using the PASCAL Ace in a challenging small-annulus anatomy. Dr Neil Fam closes by expanding the horizon, addressing MAC, screen failure and when TMVR should be the first conversation, not the last resort.