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Related Concept Videos

Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
274
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

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The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
206
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

154
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
154
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

199
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

207
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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Screening for transcatheter mitral valve replacement: a decision tree algorithm.

Sebastian Ludwig1, Nicole Ruebsamen, Florian Deuschl

  • 1Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|April 15, 2020
PubMed
Summary
This summary is machine-generated.

A new screening algorithm helps identify suitable patients for transcatheter mitral valve replacement (TMVR) by assessing anatomical eligibility. This tool addresses high screening failure rates in severe mitral regurgitation (MR) patients.

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Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Screening failure due to anatomical issues limits transcatheter mitral valve replacement (TMVR) in severe mitral regurgitation (MR) patients.
  • Optimal patient selection criteria for TMVR remain poorly defined, hindering effective screening.

Purpose of the Study:

  • To develop a novel screening algorithm for assessing anatomical eligibility for TMVR.
  • To utilize existing TMVR screening data to create a predictive model for patient selection.

Main Methods:

  • Analysis of 195 screenings across six TMVR devices in 94 high-risk severe MR patients.
  • Comparison of echocardiographic and multislice computed tomography (MSCT) parameters between accepted and rejected patients.
  • Statistical derivation of a decision tree algorithm based on screening failure reasons.

Main Results:

  • Identified key anatomical reasons for screening failure: small left ventricular (LV) dimensions, suboptimal annular size, LV outflow tract (LVOT) obstruction risk, and mitral annulus calcification.
  • Developed a four-step decision tree algorithm demonstrating an AUC of 0.80 (95% CI: 0.71–0.89) for predicting TMVR eligibility.
  • The algorithm effectively differentiates between patients anatomically suitable and unsuitable for TMVR.

Conclusions:

  • This study introduces the first screening algorithm for anatomical TMVR eligibility in severe MR patients.
  • The algorithm is based on straightforward multislice computed tomography (MSCT) criteria, simplifying patient assessment.
  • By potentially reducing screening failures, this algorithm can improve the identification of appropriate candidates for TMVR.