Treatment of Concomitant Mitral Regurgitation by Mitral Valve Clipping in Patients With Successful Transcatheter Aortic Valve Implantation.

Inclusion criteria * Planned transfemoral TAVI using an Edwards Sapien 3 Transcatheter Heart Valve (or subsequent models) * Moderate to severe mitral regurgitation * Symptom status NYHA II-III * Treatment and compliance with optimal, individually-tailored guideline directed medical therapy for heart failure for at least 30 days before inclusion * Age ≥ 18 and \< 90 years * Written informed consent Exclusion criteria * MR mechanism/anatomy precluding MitraClip therapy * Groin blood vessels are not eligible for TAVI procedure * Massive or torrential tricuspid regurgitation * Patients who cannot tolerate procedural anticoagulation or post procedural anti-platelet regimen. * Life expectancy \< 1 year due to non-cardiac conditions * LVEF ≤ 25% * Hypotension (systolic pressure \< 90 mmHg) or requirement of inotropic support or mechanical hemodynamic support * Cardiomyopathy other than dilated cardiomyopathy * Fixed pulmonary artery systolic pressure \> 70 mm Hg * Any prior mitral valve surgery or transcatheter mitral valve procedure * Stroke or transient ischemic event within 6 months prior to randomization * Severe symptomatic carotid stenosis * Implant or revision of any rhythm management device (CRT or CRT-D) or implantable cardioverter defibrillator within 90 days prior to randomization * Untreated clinically significant coronary artery disease requiring revascularization * Any percutaneous cardiac intervention or carotid surgery within the 30 days prior to randomization, or any cardiac surgery within six months prior to randomization. * Need for any other cardiovascular surgery (other than MV or AV disease) * Echocardiographic evidence of intracardiac mass, thrombus, or vegetation * Active endocarditis or active infections requiring current antibiotic treatment * Any condition making it unlikely that the patient will be able to complete all protocol procedures * Patient unable to provide written informed consent prior to study enrolment * Pregnant or nursing women * Women of child bearing potential * Current participation in any other interventional clinical trial * Patients under legal supervision or guardianship Patients placed in an institution by official or court order