Functional MR secondary to LV dysfunction remains a significant clinical problem, representing an independent or strong predictor of mortality in patients with both ischemic and non-ischemic heart failure.Although medical therapies play a leading role in alleviating this complication, recent data suggest that mitral valve repair also appears promising.Recently technological advances have enabled mitral valve repair to be performed using endovascular techniques.Numerous devices have been developed for the percutaneous treatment of as well as mitral regurgitation.An current overview of the rationale for using the coronary sinus for percutaneous mitral annuloplasty, edge to edge mitral leaflet suture method, direct atrioventricular grove cinching methods, and other percutaneous approaches to directly address mitral valvular pathology is addressed reviewing basic anatomy, pre-interventional patient evaluation, current prototypes and current clinical results.