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Management After Secondary Mitral Valve Repair

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Abstract

The primary objective of mitral valve repair for secondary mitral regurgitation is to obtain a competent mitral valve. The secondary objective, by removing the ventricular volume overload is to prevent further deterioration of left ventricular function, and possibly improve left ventricular function by reverse remodelling. Patients with secondary mitral regurgitation, in contrast to degenerative mitral valve disease, have a higher risk of recurrent mitral regurgitation after initially successful mitral valve surgery. Hence, assessment and follow up of the mitral valve repair relies on more frequent routine echocardiography examinations (2D, 3D) including mitral valve parameters to detect mitral regurgitation recurrence, as well as left and right ventricle function and pulmonary hypertension. Post operative management includes anticoagulation to reduce thrombo-embolic risks, optimal medical therapy for heart failure including ACE inhibitors, beta blockers, spirinolactone and diuretics when indicated. Reoperation, ventricular assist devices or heart transplantation may need to be considered after mitral valve repair in patients who have continued symptoms of heart failure despite optimal medical and non-pharmacological therapy such as cardiac resynchronisation therapy.

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Author information

Authors and Affiliations

  1. University Hospital of Wales, Cardiff, UK

    Ulrich O. von Oppell

  2. Groupement des Hôpitaux de l’Institut Catholique de Lille, Université Catholique de Lille, Lille, France

    Sylvestre Maréchaux

  3. Centre Hospitalier Universitaire d’Amiens, Amiens, France

    Christophe Tribouilloy

Authors
  1. Ulrich O. von Oppell
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  2. Sylvestre Maréchaux
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  3. Christophe Tribouilloy
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Corresponding author

Correspondence to Ulrich O. von Oppell .

Editor information

Editors and Affiliations

  1. GVM Care and Research Group, University of Palermo, Palermo, Italy

    Khalil Fattouch

  2. CHU Sart Tilman, University of Liège, Liège, Belgium

    Patrizio Lancellotti

  3. Hammersmith Hospital, Imperial College of London, London, United Kingdom

    Gianni D. Angelini

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von Oppell, U.O., Maréchaux, S., Tribouilloy, C. (2015). Management After Secondary Mitral Valve Repair. In: Fattouch, K., Lancellotti, P., Angelini, G. (eds) Secondary Mitral Valve Regurgitation. Springer, London. https://doi.org/10.1007/978-1-4471-6488-3_21

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  • DOI: https://doi.org/10.1007/978-1-4471-6488-3_21

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  • Online ISBN: 978-1-4471-6488-3

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