Outcomes in Degenerative Mitral Regurgitation: Current State-of-the Art and Future Directions

Prog Cardiovasc Dis. 2017 Nov-Dec;60(3):370-385. doi: 10.1016/j.pcad.2017.10.005. Epub 2017 Nov 9.

Abstract

Mitral regurgitation (MR) is the one of the most frequent valvular heart diseases in the developed world, often requiring surgical correction. Degenerative MR is the most common type of non-ischemic, organic MR in the western world. Since no medical treatment has been shown to be effective in preventing the consequences of volume overload in asymptomatic degenerative MR, risk stratification is essential. Currently, this is achieved using clinical and precisely quantified echocardiographic parameters, with newer technologies like cardiac magnetic resonance gaining increasing prominence. While surgical mitral repair, often performed using minimally invasive/robotic techniques, is the current gold-standard for definitive therapeutic management, there is rapid emergence of percutaneous techniques for mitral valve repair/replacement in cases of degenerative MR. This state-of-the-art-review will discuss the latest knowledge in the natural history, imaging, surgical and percutaneous therapies in patients with degenerative MR.

Keywords: Degenerative mitral regurgitation; Minimally invasive mitral surgery; Outcomes; Transcatheter mitral valve therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheterization / trends*
  • Diffusion of Innovation
  • Echocardiography / trends
  • Forecasting
  • Heart Valve Prosthesis / trends
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / trends*
  • Hemodynamics
  • Humans
  • Mitral Valve Annuloplasty / adverse effects
  • Mitral Valve Annuloplasty / instrumentation
  • Mitral Valve Annuloplasty / trends*
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / physiopathology
  • Mitral Valve Insufficiency* / surgery
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / physiopathology
  • Mitral Valve* / surgery
  • Recovery of Function
  • Treatment Outcome