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Mitral Valve Prolapse I: Introduction

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...

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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 tachycardia.

Mitral Regurgitation III: Medical Management

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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 Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...

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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...

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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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

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Racial Disparities in Access to High-Volume Mitral Valve Transcatheter Edge-to-Edge Repair Centers.

Diala Steitieh¹, Alyssa Zaidi², Shirley Xu³

¹Division of Cardiology, Department of Medicine, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York.

Journal of the Society for Cardiovascular Angiography & Interventions

|August 12, 2024

Summary

Racial minorities, especially Black and Hispanic patients, are less likely to receive transcatheter edge-to-edge repair (TEER) at high-volume centers. Hispanic patients also face higher in-hospital mortality after TEER.

Keywords:

disparities edge-to-edge minorities transcatheter edge-to-edge repair transcatheter mitral valve repair

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Area of Science:

Cardiovascular Medicine
Health Services Research
Health Equity

Background:

Severe mitral regurgitation is a serious condition with significant morbidity and mortality.
Transcatheter edge-to-edge repair (TEER) offers an alternative to surgery for high-risk patients.
Existing data lack information on racial disparities in access to high-volume TEER centers.

Purpose of the Study:

To investigate racial disparities in access to high-volume transcatheter edge-to-edge repair (TEER) centers.
To assess the association between patient race and the likelihood of undergoing TEER at high-volume facilities.
To examine in-hospital mortality and home discharge rates based on TEER center volume and patient race.

Main Methods:

Analysis of 2016 State Inpatient Databases from eight US states.
Inclusion of 1567 hospitalizations for transcatheter edge-to-edge repair (TEER).
Comparison of patient characteristics, outcomes, and likelihood of treatment at high-volume (≥25 procedures/year) versus low-volume centers, stratified by race.

Main Results:

Black and Hispanic patients were significantly less likely than White patients to undergo TEER at high-volume centers (OR 0.41, P < .001 and OR 0.49, P < .001, respectively).
Hispanic patients had a 3-fold increased likelihood of in-hospital mortality compared to White patients (OR 3.32, P = .027).
Geographic clustering of TEER centers was observed, with high-volume centers located in areas with a higher proportion of White residents.

Conclusions:

Racial and ethnic minorities, particularly Black and Hispanic individuals, face significant barriers to accessing high-volume transcatheter edge-to-edge repair (TEER) centers.
Hispanic patients undergoing TEER experience disproportionately higher in-hospital mortality rates compared to White patients.
Findings highlight critical racial disparities in advanced cardiovascular care access and outcomes, necessitating targeted interventions to promote health equity.