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Updated: Jul 18, 2025
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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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Mitral Interventions in Heart Failure
Matthew M Lander1, Michael I Brener2, Kashish Goel3
1Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
JACC. Heart Failure
|August 23, 2023
Summary
Secondary mitral regurgitation (SMR) in heart failure with reduced ejection fraction worsens outcomes. Transcatheter edge-to-edge repair offers a promising percutaneous intervention, expanding treatment options for these patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Heart Failure Management
Background:
- Secondary mitral regurgitation (SMR) in heart failure with reduced ejection fraction (HFrEF) is linked to adverse patient outcomes and diminished quality of life.
- Guideline-directed medical therapy remains the primary treatment approach for SMR.
Purpose of the Study:
- To review the evolving role of transcatheter edge-to-edge repair (TEER) for SMR in HFrEF patients.
- To identify patient subgroups likely to benefit from percutaneous interventions.
- To explore the potential of TEER in previously unstudied populations.
Main Methods:
- Analysis of landmark clinical trials focusing on TEER for SMR.
- Emphasis on a multidisciplinary approach to patient selection and management.
- Evaluation of emerging transcatheter devices and ongoing clinical trials.
Main Results:
- Landmark trials have refined the understanding of patient selection for TEER in SMR.
- TEER success has prompted its investigation in advanced heart failure populations, including cardiogenic shock.
- A growing pipeline of transcatheter devices is expanding therapeutic options.
Conclusions:
- TEER is an increasingly important percutaneous intervention for symptomatic SMR in HFrEF.
- A multidisciplinary strategy is crucial for optimizing outcomes with TEER.
- Future transcatheter innovations promise further advancements in managing HFrEF with SMR.
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