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Mitral valve prolapse

Aeshah Althunayyan1,2, Steffen E Petersen1,2, Guy Lloyd1,2,3

  • 1a Barts Heart Centre, St Bartholomew's Hospital , Barts Health NHS Trust , London , UK.

Expert Review of Cardiovascular Therapy
|November 29, 2018
PubMed

Insights

Mitral valve prolapse (MVP) management is complex. For asymptomatic severe mitral regurgitation, risk stratification is crucial to determine optimal intervention timing, as progression factors and complication prevention remain unclear.

Area of Science:

  • Cardiology
  • Valvular Heart Disease

Background:

  • Mitral valve prolapse (MVP) is a common cardiac condition with varied severity, from isolated prolapse to Barlow's disease.
  • Complications include mitral regurgitation, endocarditis, sudden cardiac death, and stroke.
  • Optimal intervention timing for asymptomatic severe mitral regurgitation remains a clinical dilemma.

Purpose of the Study:

  • To review the pathophysiology, genetics, clinical features, diagnostic imaging, complications, outcomes, and intervention indications for MVP.
  • To discuss current challenges and controversies in MVP management.

Main Methods:

  • Literature review of pathophysiology, genetics, clinical presentation, imaging, complications, and outcomes of MVP.
  • Analysis of current evidence regarding indications for intervention in symptomatic and asymptomatic patients.

Main Results:

  • Progression factors for mitral regurgitation in MVP are not well-defined, limiting targeted preventative therapies.
  • Evidence-based strategies to mitigate risks of sudden death, stroke, and endocarditis in MVP are lacking.
  • Surgical intervention is recommended for symptomatic severe mitral regurgitation.

Conclusions:

  • Management of MVP requires careful risk stratification in asymptomatic patients, considering left ventricular function, atrial fibrillation, pulmonary hypertension, and valve repairability.
  • Further research is needed to identify factors influencing MVP progression and to develop preventative strategies for major complications.
Keywords:
Mitral valve prolapsecardiac surgerydegenerative mitral regurgitationechocardiographyheart valvesmitral regurgitation

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