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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

20
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...
20
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

27
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...
27
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

39
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...
39
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

38
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...
38
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

53
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
53
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

34
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...
34

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Related Experiment Video

Updated: Sep 8, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Transcatheter Mitral Valve Replacement Using Contemporary Dedicated Devices: A Systematic Review and Meta-Analysis.

Mark J Zorman1,2, Katerina Dangas1, Jonathan Vibhishanan1

  • 1Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Structural Heart : the Journal of the Heart Team
|August 20, 2025
PubMed
Summary

Dedicated transcatheter mitral valve replacement (TMVR) offers a promising solution for mitral regurgitation (MR). Transseptal access shows better outcomes than transapical, though further research is needed for long-term improvements.

Keywords:
Mitral regurgitationTransapical accessTranscatheter mitral valve replacementTransseptal access

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Transcatheter mitral valve replacement (TMVR) is an emerging treatment for high-risk patients with complex mitral regurgitation (MR).
  • Dedicated TMVR devices are increasingly utilized via transapical and transseptal approaches.
  • Evaluating outcomes of contemporary TMVR devices in native MR is crucial.

Purpose of the Study:

  • To assess procedural, 30-day, and midterm outcomes of TMVR using dedicated devices in patients with native MR.
  • To compare outcomes between transapical and transseptal access routes for TMVR.
  • To identify areas for improvement in TMVR patient care.

Main Methods:

  • Systematic literature search of Medline, Embase, and Cochrane Library (2010-2025).
  • Pooled analysis of 13 studies including 914 patients with native MR, excluding legacy devices and mitral stenosis.
  • Random-effects models used to derive outcome estimates.

Main Results:

  • High technical success rate (96.3%) with sustained MR reduction (mild or less in 99% at 30 days, 98% at 1 year).
  • 30-day all-cause mortality was 11.0%, increasing to 26.4% at 1 year.
  • Transseptal access demonstrated lower 30-day and 1-year mortality and major bleeding compared to transapical access.

Conclusions:

  • Contemporary dedicated TMVR devices achieve high technical success and effective MR reduction.
  • Transseptal access is linked to reduced morbidity and mortality compared to transapical.
  • Further research is warranted to enhance long-term survival and reduce heart failure hospitalizations post-TMVR.