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Related Concept Videos

Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

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 I: Introduction01:22

Mitral Stenosis I: Introduction

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...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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

Mitral Valve Prolapse II: Assessment and Management

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.

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Updated: May 24, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

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Published on: October 16, 2021

Left Ventricular Function and Atrial Remodeling Shape Outcomes After Mitral-Transcatheter Edge-to-Edge Repair.

Louise Rouleau1, Marina Petersen Saadi1, Adrien Al Wazzan1

  • 1University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France.

ESC Heart Failure
|May 22, 2026
PubMed
Summary

Mitral transcatheter edge-to-edge repair (M-TEER) benefits heart failure patients with secondary mitral regurgitation, regardless of left ventricular ejection fraction (LVEF). Enlarged left atrium indicates higher mortality risk, suggesting earlier intervention.

Keywords:
left atrial volumeleft ventricular ejection fractionsecondary mitral regurgitation

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Published on: December 11, 2017

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Heart Failure Management

Background:

  • Secondary mitral regurgitation (SMR) significantly impacts heart failure morbidity and mortality.
  • Mitral transcatheter edge-to-edge repair (M-TEER) shows promise for SMR, particularly in patients with reduced left ventricular ejection fraction (LVEF).
  • Limited evidence exists for M-TEER efficacy in patients with preserved LVEF, often associated with atrial functional mitral regurgitation.

Purpose of the Study:

  • To evaluate the effectiveness and outcomes of M-TEER in patients with symptomatic SMR across the LVEF spectrum.
  • To identify predictors of clinical improvement and mortality following M-TEER.
  • To assess the role of left atrial volume index (LAVI) in predicting outcomes after M-TEER.

Main Methods:

  • Retrospective analysis of 93 consecutive patients with symptomatic SMR undergoing M-TEER (2018-2022).
  • Patients stratified by LVEF (<50% vs ≥50%) and LAVI (<60 vs ≥60 mL/m²).
  • Primary endpoint: comprehensive clinical improvement at 36 months (survival, NYHA class, KCCQ score); Kaplan-Meier and Cox analyses used.

Main Results:

  • 55% of 87 patients with follow-up achieved the composite endpoint.
  • Clinical improvement rates were similar between reduced and preserved LVEF groups (51.8% vs 62.5%).
  • All-cause mortality at 36 months was lower in preserved LVEF (9.4%) vs reduced LVEF (29.6%). Enlarged LAVI (≥60 mL/m²) was linked to increased mortality (29.4% vs 11.8%).

Conclusions:

  • M-TEER offers sustained clinical benefit for SMR patients across the LVEF spectrum, including those with preserved LVEF.
  • Left atrial enlargement (LAVI ≥60 mL/m²) is a significant predictor of worse prognosis and higher mortality.
  • Atrial enlargement may indicate advanced atrial disease, supporting consideration for earlier intervention in SMR management.