At present, patient selection involves a consensus between the patients and treating physicians as well as agreement that the patient is anatomically eligible based on TTE and TEE findings.

Clinical indications include:

1. Patients who are at high risk for surgery (excessive co-morbidity). This may include patients with advancedchronic obstructive airway disease, renal failure, diabetes mellitus etc.
2. Patients with previous cardiac surgery for whom any re-do operation increases the peri-operative risk. Thisincludes patients with functional MR after CABG surgery.
3. Patients who decline surgery.