Review ArticlesTranscatheter Mitral Valve Replacement Design Implications, Potential Pitfalls and Outcomes AssessmentTang, Gilbert H. L. MD, MSc, MBA*; George, Isaac MD†; Hahn, Rebecca T. MD‡; Bapat, Vinayak MD§; Szeto, Wilson Y. MD‖; Kodali, Susheel K. MD‡Author Information From the *Section of Cardiothoracic Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY; †Division of Cardiothoracic Surgery, ‡Division of Cardiology, New York Presbyterian Hospital, College of Physicians and Surgeons of Columbia University, New York, NY; §Department of Cardiothoracic Surgery, St. Thomas’ Hospital, London, United Kingdom; and ‖Division of Cardiovascular Surgery, University of Pennsylvania Medical Center, Philadelphia, PA. Disclosures: Dr. Tang is a physician proctor for Edwards Lifesciences and Medtronic. Dr. George is on the Data Safety Monitoring Board for Tendyne Medical and co-investigator on the early feasibility trial for the Tiara transcatheter mitral replacement device (Neovasc Medical Inc.). Mr. Bapat is consultant to Edwards Lifesciences LLC, Boston Scientific, Medtronic Inc., and Sorin Medical. Dr. Kodali receives grant/research support from Edwards Lifesciences LLC, Medtronic Inc., Boston Scientific Inc., and Claret Medical Inc. He is on the Steering Committee at Edwards Lifesciences, Claret Medical and Meril Inc. He also receives speaker honoraria from St. Jude Medical Inc. and Claret Medical. Correspondence: Gilbert H. L. Tang, MD, MSc, MBA, Section of Cardiothoracic Surgery, Westchester Medical Center, 100 Woods Road, Macy 114W, Valhalla, NY 10595. E-mail: TangG@wcmc.com. Cardiology in Review: November/December 2015 - Volume 23 - Issue 6 - p 290-296 doi: 10.1097/CRD.0000000000000086 Buy Metrics Abstract Transcatheter mitral valve replacement (TMVR) is an emerging new treatment option in patients with advanced mitral valve disease deemed a high or prohibitive risk for surgery. Designing an ideal TMVR device requires a detailed understanding of different mitral valve pathologies and the complex, dynamic anatomy and physiology of the mitral apparatus. This review aims to critically evaluate design implications in TMVR in the context of mitral valve disease, imaging prerequisites, procedural approaches, potential complications, and outcomes assessment. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.