Furthermore, M-TEER/LAAO may offer a feasible alternative for inoperable patients with severe symptomatic MR and AF who are partially or completely resistant to vitamin K antagonists, primarily due to mutations in the vitamin K epoxide reductase complex 1 (VKORC1) gene [39], as well as for those who are non-responders to novel direct oral anticoagulants (DOACs). The gene discussed is VKORC1; the disease is atrial fibrillation.