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Addressing the Left Ventricle in Functional Mitral Regurgitation

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Functional Mitral and Tricuspid Regurgitation

Abstract

Functional ischemic mitral regurgitation may occur as part of the complex process of left ventricular remodeling and affects the prognosis unfavourably. Chronic ischemic MR occurs in approximately 30 % of patients followed up after a myocardial infarction and in 50 % of those with post-infarct congestive heart failure. The treatment of ischemic mitral regurgitation is still debated. Medical management alleviates symptoms but does not alter the progression of the disease. The matter of surgery for ischemic mitral regurgitation, in terms of whether, when and how it should be corrected is still considerably controversial. Surgery is recommended for moderate-to-severe or severe mitral regurgitation in patients with symptoms or evidence of left ventricular dysfunction. Myocardial revascularization paired to valve surgery can be performed to treat the underlying coronary artery disease. Surgical Ventricular Reconstruction offers either the possibility to repair the mitral valve through the left ventricular opening or the potential of improving mitral functioning by reducing left ventricular volumes and rebuilding a more normal geometry.

This chapter will discuss the principles of treatment for ischemic mitral regurgitation according to the different phenotypes of left ventricular remodelling, the surgical techniques and the results, focusing on which patients may have greater benefit to the best of our knowledge.

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Author information

Authors and Affiliations

  1. Division of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milan, 20097, Italy

    Serenella Castelvecchio MD, FESC

  2. Department of Cardiac Surgery, I.R.C.C.S., Policlinico San Donato, Milan, Italy

    Andrea Garatti MD & Lorenzo Menicanti MD, FECTS

Authors
  1. Serenella Castelvecchio MD, FESC
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  2. Andrea Garatti MD
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  3. Lorenzo Menicanti MD, FECTS
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Corresponding author

Correspondence to Serenella Castelvecchio MD, FESC .

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Editors and Affiliations

  1. Department of Cardiothoracic Surgery, Gleneagles Hospital, Kuala Lumpur, Malaysia

    Kok Meng John Chan

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Castelvecchio, S., Garatti, A., Menicanti, L. (2017). Addressing the Left Ventricle in Functional Mitral Regurgitation. In: Chan, K. (eds) Functional Mitral and Tricuspid Regurgitation. Springer, Cham. https://doi.org/10.1007/978-3-319-43510-7_13

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  • DOI: https://doi.org/10.1007/978-3-319-43510-7_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43508-4

  • Online ISBN: 978-3-319-43510-7

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