By Ted Feldman, Frederick St Goar
Mitral regurgitation (MR) impacts hundreds of thousands of sufferers around the globe. it's a progressive condition that can aggravate while left untreated, almost certainly top to compensatory home improvement of the left ventricle. This can lead to decreased sensible means, negative caliber of existence, repeat hospitalizations, or even loss of life from middle failure. Open, arrested middle surgical procedure has beforehand been the healing therapy of selection. in spite of the fact that, many high-risk sufferers can't tolerate conventional middle surgical procedure and proceed to be afflicted by serious MR.
In Percutaneous Mitral Leaflet fix: MitraClip treatment for Mitral Regurgitation, international experts talk about the scientific software of percutaneous mitral valve treatments for this subsect of sufferers, targeting the MitraClip device. These new healing advancements will shape a vital part of the interventional cardiologists’ armamentarium in treating MR sufferers and should be of curiosity to each working towards heart specialist.
Key themes include:
- An assessment of the anatomy and pathophysiology of the mitral valvular advanced and MR
- EVEREST trial results, and the improvement of percutaneous edge-to-edge repair
- Updates at the international adventure with this new therapy
- Patient choice and the function of percutaneous treatments for high-risk patients
- Echocardiographic advice, together with functional suggestions for using transesophageal echocardiography in the course of a procedure
- Step-by-step innovations, plus assistance and methods for buying the easiest effects to your patients
- Special issues for treating the returning MR fix sufferer
- Discussion of the ecu adventure due to the fact that CE approval
- Future instructions in percutaneous mitral valve therapies
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Extra resources for Percutaneous mitral leaflet repair: MitraClip therapy for mitral regurgitation
Sample text
Eur J Cardiothorac Surg 2002; 22: 817–20. 17. Brinster DR, Unic D, D’Ambra MN, et al. Midterm results of the edge-to-edge technique for complex mitral valve repair. Ann Thorac Surg 2006; 81: 1612–17. 18. Mascagni R, Al Attar N, Lamarra M, et al. Edge-to-edge technique to treat post-mitral valve repair systolic anterior motion and left ventricular outflow tract obstruction. Ann Thorac Surg 2005; 79: 471–3. 19. Ando M, Takahashi Y. Edge-to-edge repair of common atrioventricular or tricuspid valve in patients with functionally single ventricle.
Pereda D, Topilsky Y, Nishimura RA, Park SJ. Asymmetric Alfieri’s stitch to correct systolic anterior motion after mitral valve repair. Eur J Cardiothorac Surg 2010. com by Nyu Medical Center on 07/30/12 For personal use only. 5 million people in the United States, a number that is expected to double by 2030 (1). With this disease prevalence, mitral valve surgery constitutes up to one-third of all cardiac procedures. When evaluating mitral disease, regurgitation and stenosis are considered separately.
The technique has been used to treat secondary MR in patients undergoing aortic valve surgery, to reduce the operative times and control the operative risk, usually with a transaortic approach. Although we have been using the technique to treat rheumatic disease patients, we discontinued to do so, due to poor long-term outcomes and owing to the intrinsic risk of high transvalvular gradients in the presence of leaflets with limited pliability (3). EDGE-TO-EDGE WITHOUT ANNULOPLASTY The addition of annuloplasty at the end of leaflet repair is a standard practice in surgical mitral repair, due to the evidence of better early and long-term results in the overall population (15).