Mitral valve surgery is the gold standard therapy for severe mitral regurgitation, but can be associated with significant morbidity and mortality. Percutaneous mitral leaflet repair has recently been established as a viable alternative to surgery, but many patients are ineligible and repair may not be optimal. Transcatheter mitral valve implantation may be an alternate therapeutic option, particularly for high-risk patients. We outline the initial preclinical and first-in-human experience with

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... he Tiara transapical mitral valve implantation system, highlighting the ease of implantation, proven feasibility and excellent haemodynamic performance. KEYWORDS • mitral regurgitation • mitral valve implantation • mitral valve replacement • transapical • transcatheter Figure 5. Tiara valve deployed. A, B) Full deployment and release from the delivery catheter. C) Coronary angiogram showed a patent and uncompressed circumflex artery. D) Transoesophageal echocardiography documented a well-seated Tiara bioprosthesis.