Mitral regurgitation and its modern treatments

Jerzy Pręgowski

Abstract


Mitral regurgitation is the second most common valvular disease. The etiology is either primary or functional-secondary  to the left ventricle dysfunction in the course of coronary artery disease, arterial hypertension and diabetes. Along with the population aging and increasing number of comorbidities the number of patients with mitral regurgitation soars. In patients with heart failure the mitral regurgitation significantly decreases the quality of life and worsens the survival prognosis. Surgical correction is the treatment of choice in patients with mitral regurgitation. However, up to 50% of potential candidates are denied surgery for its prohibitive risk. The minimally invasive, percutaneus procedures are potential solution for those subjects. Currently the „edge to edge” technique with use of the MitraClip system is most commonly performed. This procedure is less efficient in MR reduction than open heart surgery. However, the number of periprocedural complications is smaller. It has been shown the MR correction with the MitraClip device improves the duration and quality of life. There are several ongoing preclinical studies on the percutaneusly implanted mitral valve prosthesis. First in men procedures have been performed. However the mitral valve anatomy is much more complex as compared to aortic. Therefore the breakthrough comparable to TAVI procedure will not occur in the very close future.

Keywords


mitral regurgitation; heart failure; percutaneus intervention

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