Mitral Valve Replacement With MValve Dock and Lotus

Inclusion Criteria: * Symptomatic ≥3+ degenerative or functional mitral regurgitation of either ischemic or non-ischemic etiology based by a qualifying echocardiography obtained within 90 days prior to the procedure. * New York Heart Association (NYHA) Functional Class III or IV. * High risk for conventional open mitral valve repair or replacement surgery in the consideration of the site Heart Team. * Left Ventricular Ejection Fraction (LVEF) is ≥30% within 30 days prior to the procedure. * Mitral valve annular commissure to commissure (C/C) dimension between 30-35 mm by echocardiography. * Left atrial diameter \<5.5 cm by echocardiography Exclusion Criteria: * Prior mitral valve replacement or repair surgery. * Prior transapical surgery. * Severe aortic or tricuspid valve disease. - Severe symptomatic carotid stenosis (\>70% by ultrasound). * ACC/AHA Stage D heart failure. * Hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis, or any other structural heart disease causing heart failure other than dilated cardiomyopathy of either ischemic or non-ischemic etiology. * Infiltrative cardiomyopathies (amyloidosis, hemochromatosis, sarcoidosis). * Physical evidence of right-sided congestive heart failure with echocardiographic evidence of moderate or severe right ventricular dysfunction. * Severe mitral annular calcification. * Glomerular filtration rate (GFR) \< 30. * Hemodynamic instability defined as systolic pressure \< 90 mm Hg with or without afterload reduction, cardiogenic shock, or the need for inotropic support or intra-aortic balloon pump or other hemodynamic support device, or any mechanical heart assistance.