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Related Concept Videos

Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

120
Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
120

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Insight from International Guidelines: do We Have Satisfactory Recommendations for Secondary Mitral Regurgitation?

Francesco Nappi1, Sanjeet Singh Avtaar Singh2, Antonio Fiore3

  • 1Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed
Summary

New guidelines address secondary mitral regurgitation management, incorporating transcatheter edge-to-edge repair (TEER). Shared decision-making and optimal medical therapy are emphasized before mechanical interventions.

Keywords:
international guidelinesmitral valve surgerysecondary mitral regurgitationtranscatheter edge to edge valve repair

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Guidelines

Background:

  • Recent guidelines from ESC and ACC/AHA address secondary mitral regurgitation (SMR).
  • These guidelines define, classify, and assess SMR severity.
  • They incorporate transcatheter edge-to-edge repair (TEER) into decision-making.

Purpose of the Study:

  • Review strengths and weaknesses of studies on TEER for SMR.
  • Assess applicability of results for heart team decision-making.
  • Highlight the role of shared decision-making in SMR management.

Main Methods:

  • Analysis of recent European Society of Cardiology (ESC) and American College of Cardiology (ACC/AHA) guidelines.
  • Review of studies evaluating transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation.
  • Emphasis on echocardiography and guideline-directed medical therapy.

Main Results:

  • Guidelines incorporate TEER, but require further validation.
  • Optimal medical therapy is the first-line treatment.
  • Multidisciplinary heart team approach is crucial for intervention selection.

Conclusions:

  • Shared decision-making is vital for managing secondary mitral regurgitation.
  • Guideline-directed medical therapy should precede mechanical interventions.
  • Further high-quality studies are needed to guide decisions on TEER, replacement, or repair.