Table 2. Everest criteria (4).

Major inclusion criteria	Major exclusion criteria
Moderate-severe (3+) or severe (4+) chronic MR and	Acute myocardial infarction in the prior 12 weeks of the intended treatment
Symptomatic with >25% left ventricular ejection fraction and left ventricular end-systolic diameter ≤55 mm or	The need for any other cardiac surgery
Asymptomatic with one or more of the following:	Any endovascular therapeutic interventional or surgical procedure performed within 30 days prior
(I) LVEF 25% to 60%	Ejection fraction b25%, and/or end-systolic dimension >55 mm
(II) LVESD ≥40 mm	MV orifice area <4.0 cm2
(III) New onset of atrial fibrillation	If leaflet flail is present, width of the flail segment ≥15 mm, or flail gap ≥10 mm
(IV) Pulmonary hypertension defined as pulmonary artery systolic pressure >50 mm Hg at rest or >60 mmHg with exercise	Severe mitral annular calcification
Candidate for MV repair or replacement surgery, including cardiopulmonary bypass	If leaflet tethering is present, coaptation depth >11 mm, or vertical coaptation length is <2 mm
The primary regurgitant jet originates from malcoaptation of the A2 and P2 scallops of the MV. If a secondary jet exists, it must be considered clinically insignificant	Leaflet anatomy that may preclude clip implantation, proper clip positioning on the leaflets, or sufficient reduction in MR. This may include the following:
	Evidence of calcification in the grasping area of the A2 and/or P2 scallops
	Presence of a significant cleft of A2 or P2 scallops
	More than 1 anatomic criteria dimensionally near the exclusion limits
	Bileaflet flail or severe bileaflet prolapse
	Lack of both primary and secondary chordal support
	Prior MV surgery or valvuloplasty or any currently implanted mechanical prosthetic valve or currently implanted ventricular assist device
	Echocardiographic evidence of intracardiac mass, thrombus, or vegetation
	History of or active endocarditis or rheumatic heart disease
	History of atrial septal defect or patent foramen ovale associated with clinical symptoms