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Mitral Valve Interventions in Structural Heart Disease

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
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Abstract

Purpose of review

Analyze the current state of the art and the future perspectives of mitral interventions in clinical setting.

Recent Findings

A systematic and critical review of the new mitral percutaneous therapies and imaging technologies is the basis to adopt the right treatment for each patient according to specific valve dysfunction and clinical presentation, waiting for definitive guidelines. While surgical mitral repair will remain the gold standard for low-risk healthy patients with degenerative mitral regurgitation (DMR), transcatheter mitral valve repair is becoming first line therapy in high risk patients with functional mitral regurgitation (FMR). The introduction of transcatheter mitral valve replacement will expand indications for advanced DMR and FMR in inoperable patients.

Summary

The introduction of transcatheter mitral interventions is changing the mitral therapy scenario. Mitral interventionalists might evolve into hybrid professional figures able to offer a tailored approach for each patient, including surgical and percutaneous approaches, depending on the anatomo-functional status of the valve, to clinical conditions, and to the timing of the intervention.

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Abbreviations

6MWT:

MWT 6 minutes walking test

DMR:

Degenerative Mitral Regurgitation

LVEF:

Left ventricular ejection fraction

MLHFQ:

Minnesota Living with Heart Failure questionnaire

MVR:

Mitral valve repair

NYHA:

New York Heart Association

ePTFE:

Polytetrafluoroethylene

TMVI:

Transcatheter mitral valve implantation

TMVRep:

Transcatheter mitral valve repair

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Authors and Affiliations

  1. Heart Center University Hospital of Zurich, Department of Cardiac Surgery - UniversitätsSpital Zürich, Ramistrasse 100, 8091, Zürich, Switzerland

    Matteo Saccocci, Maurizio Taramasso & Francesco Maisano

Authors
  1. Matteo Saccocci
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  2. Maurizio Taramasso
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  3. Francesco Maisano
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Correspondence to Francesco Maisano.

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Conflict of Interest

Matteo Saccocci has no conflicts of interest to declare.

Maurizio Taramasso is a consultant for Abbott Vascular and 4Tech Cardio, and Boston Scientific.

Francesco Maisano is a consultant for Abbot Vascular, Edwards Lifesciences, ValtechCArdio, Mitraltech, Medtronic, St. Jude, and Xeltis. He is the co-founder and a shareholder of 4Tech Cardio, TransSePtalsolutions, and Affix. He receives royalties from Edwards Lifesciences and grants from Abbott, St. Jude Medical, Bioventrix, and DirectFlow. He has the following patents: Deployment techniques for annuloplasty ring and overwire rotation; Tool retaining mechanisms for prosthetic valves WO2009155561 (A2); Deployment techniques for annuloplasty ring and overwire rotation tool EP2427145 (A2); Implantation of repair chords in the heart EP2427144 (A1); Method and apparatus for tricuspid valve repair using tension US2012035712 (A1); Annuloplasty Rings for Repair of Abnormal Mitral Valves US2011301704 (A1); Delivery tool for implantation of spool assembly coupled to a helical anchor US2011282361 (A1); Tricuspid valve repair using tension US2011184510 (A1); Retaining mechanisms for prosthetic valves EP2303190 (A2); Retaining Mechanisms for Prosthetic Valves US2010256751 (A1); Annular Prosthesis for a Mitral Valve US2010137980 (A1); Adjustable repair chords and spool mechanism therefor US2010161041 (A1); Dispositivo per uso in emodinamica ITMI20070906 (A1); Mezzo per vedere una valvola cardiaca in fase intraoperatoria ITMI20060963 (A1); Annuloplasty rings for repair of abnormal mitral valves WO2005034813 (A2).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Structural Heart Disease

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Saccocci, M., Taramasso, M. & Maisano, F. Mitral Valve Interventions in Structural Heart Disease. Curr Cardiol Rep 20, 49 (2018). https://doi.org/10.1007/s11886-018-0982-y

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  • DOI: https://doi.org/10.1007/s11886-018-0982-y

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