A novel percutaneous device, the MitraClip is introduced percutaneously via the femoral vein and fastened edge-to-edge to the middle scallops of the posterior and anterior leaflets of the mitral valve to create a double orifice-improving coaptation (or joining) that replicates the Alfieri surgical repair. ACC/AHA guidelines now recommend consideration of transcatheter repair for severely symptomatic patients with chronic severe primary DMR, reasonable life expectancy and high or prohibitive surgical risk attributable to severe comorbidities.