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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Degenerative mitral valve regurgitation: best practice revolution
David H Adams1, Raphael Rosenhek, Volkmar Falk
1Department of Cardiothoracic Surgery, The Mount Sinai School of Medicine, 1190 Fifth Avenue, New York, NY 10029, USA. david.adams@mountsinai.org
European Heart Journal
|July 14, 2010
Summary
Degenerative mitral valve disease requires timely intervention. Current practices often delay referrals and favor valve replacement over repair, impacting patient survival and necessitating a
Area of Science:
- Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Degenerative mitral valve disease (DMVD) causes leaflet prolapse, leading to mitral regurgitation.
- Surgical referral is guided by symptoms and ventricular dysfunction.
- Mitral valve repair is preferred over replacement for better survival outcomes.
Purpose of the Study:
- To review current clinical practices in managing degenerative mitral valve regurgitation.
- To highlight delays in patient referral and suboptimal surgical interventions.
- To advocate for a 'best practice revolution' in DMVD management.
Main Methods:
- Literature review of current guidelines and recent studies on DMVD management.
- Analysis of referral patterns and surgical intervention trends.
- Discussion of the implications for patient outcomes and future strategies.
Main Results:
- Many patients with severe mitral regurgitation are not referred for timely surgical intervention.
- A significant number of patients undergo mitral valve replacement instead of repair.
- Suboptimal clinical practice persists, particularly concerning the timing of intervention for asymptomatic severe mitral regurgitation.
Conclusions:
- Current management of DMVD is suboptimal, with delayed referrals and a high rate of valve replacement.
- There is a critical need for improved patient referral and a higher rate of mitral valve repair, especially in younger patients.
- A paradigm shift towards 'best practice' is essential to improve long-term outcomes for patients with degenerative mitral valve regurgitation.
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