[Surgical techniques in mitral valve diseases. Reconstruction and/or replacement].

Area of Science:

• Cardiology
• Cardiac Surgery
• Interventional Cardiology

Background:

• Mitral valve (MV) disease is a prevalent cardiac condition requiring complex management.
• Treatment decisions for mitral valve regurgitation (MVR) and mitral valve stenosis (MVS) necessitate a multidisciplinary approach.
• Surgical and interventional strategies are continually evolving, particularly for secondary MVR.

Purpose of the Study:

• To outline current treatment strategies for primary and secondary mitral valve regurgitation (MVR).
• To discuss management options for mitral valve stenosis (MVS).
• To highlight the role of surgical repair versus replacement and emerging percutaneous techniques.

Main Methods:

• Review of current literature and clinical guidelines for mitral valve disease management.
• Analysis of factors influencing surgical technique selection for MV repair.
• Evaluation of indications for MV replacement and choice of prosthesis.

Main Results:

• Surgical MV repair is the primary treatment for primary MVR, offering excellent outcomes.
• Concomitant MV repair is recommended for moderate secondary MVR during coronary artery bypass grafting.
• MV replacement is indicated for severe secondary MVR with high repair failure risk and for most MVS cases.

Conclusions:

• Treatment for MV disease is tailored to the specific pathology, patient risk factors, and surgeon expertise.
• Percutaneous MV replacement offers a valuable option for high-risk patients requiring reoperation.
• Optimal management of MV disease requires careful consideration of repair versus replacement and prosthesis type.