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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Functional mitral stenosis following mitral valve repair
Vincent Chan1, Thierry Mesana, Subodh Verma
1aDivision of Cardiac Surgery bSchool of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa cKeenan Research Centre for Biomedical Science dLi Ka Shing Knowledge Institute of St Michael's Hospital eDivision of Cardiac Surgery, St Michael's Hospital fDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada.
Current Opinion in Cardiology
|November 23, 2016
Summary
Functional mitral stenosis (MS) can occur after mitral valve repair for regurgitation. This condition may negatively impact patient outcomes, but research into modifiable factors is ongoing.
Area of Science:
- Cardiovascular Surgery
- Cardiac Physiology
- Valvular Heart Disease
Background:
- Functional mitral stenosis (MS) is increasingly recognized following surgical mitral valve repair.
- It has been observed in repairs for both functional and organic mitral regurgitation.
Purpose of the Study:
- To review the current evidence on functional mitral stenosis after mitral valve repair.
- To understand its implications for patient outcomes and potential modifications.
Main Methods:
- Systematic review of existing literature.
- Analysis of studies reporting on mitral valve repair outcomes.
Main Results:
- Elevated transmitral gradient and pulmonary artery pressure observed post-repair, particularly under stress.
- Functional MS linked to worse functional status early after restrictive annuloplasty for functional regurgitation.
- Functional MS also noted after organic mitral regurgitation repair, associated with late adverse outcomes.
Conclusions:
- The risk of functional MS must be balanced against the benefits of mitral valve repair, especially for functional regurgitation.
- Functional MS after degenerative mitral regurgitation repair may be amenable to modification.
- Further research is needed on repair techniques and their effect on functional MS.
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