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mitral regurgitation guidelines

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https://www.readbyqxmd.com/read/29770888/mitral-valve-interventions-in-structural-heart-disease
#1
REVIEW
Matteo Saccocci, Maurizio Taramasso, Francesco Maisano
PURPOSE OF REVIEW: Analyze the current state of the art and the future perspectives of mitral interventions in clinical setting. RECENT FINDINGS: A systematic and critical review of the new mitral percutaneous therapies and imaging technologies is the basis to adopt the right treatment for each patient according to specific valve dysfunction and clinical presentation, waiting for definitive guidelines. While surgical mitral repair will remain the gold standard for low-risk healthy patients with degenerative mitral regurgitation (DMR), transcatheter mitral valve repair is becoming first line therapy in high risk patients with functional mitral regurgitation (FMR)...
May 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29659808/knowledge-and-application-of-european-society-of-cardiology-esc-guidelines-in-the-management-of-mitral-regurgitation-this-is-not-bad-but-we-can-do-much-better
#2
Philippe Pibarot, Patrizio Lancellotti
No abstract text is available yet for this article.
April 12, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29617498/long-term-results-of-mitral-valve-repair
#3
Francisco Diniz Affonso da Costa, Daniele de Fátima Fornazari Colatusso, Gustavo Luis do Santos Martin, Kallyne Carolina Silva Parra, Mariana Cozer Botta, Eduardo Mendel Balbi Filho, Myrian Veloso, Gabriela Miotto, Andreia Dumsch de Aragon Ferreira, Claudinei Colatusso
INTRODUCTION: Current guidelines state that patients with severe mitral regurgitation should be treated in reference centers with a high reparability rate, low mortality rate, and durable results. OBJECTIVE: To analyze our global experience with the treatment of organic mitral regurgitation from various etiologies operated in a single center. METHODS: We evaluated all surgically treated patients with organic mitral regurgitation from 2004-2017...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29593831/minimally-invasive-surgical-mitral-valve-repair-state-of-the-art-review
#4
Karel M Van Praet, Christof Stamm, Simon H Sündermann, Alexander Meyer, Axel Unbehaun, Matteo Montagner, Timo Z Nazari Shafti, Stephan Jacobs, Volkmar Falk, Jörg Kempfert
Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment of mitral valve regurgitation, and indications have been expanded to include reoperations. Current European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines for the management of valvular heart disease recommended standards in terms of mitral valve disease differentiation, timing of intervention and surgical techniques to improve patient care. Numerous minimally invasive techniques to lessen the invasiveness have been described, such as the minimal-access J-sternotomy (ministernotomy), the parasternal incision, the port-access technique and the right minithoracotomy...
January 2018: Interventional Cardiology
https://www.readbyqxmd.com/read/29570209/long-term-outcomes-of-mitral-valve-annuloplasty-versus-subvalvular-sparing-replacement-for-severe-ischemic-mitral-regurgitation
#5
Baotong Li, Hengchao Wu, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
BACKGROUND: Although practice guidelines recommend surgery for patients with severe chronic ischemic mitral regurgitation (CIMR), they do not specify whether to repair or replace the mitral valve. The purpose of this study was to evaluate the long-term outcomes in patients with severe CIMR undergoing mitral valve annuloplasty (MVA) versus subvalvular sparing mitral valve replacement (MVR). METHODS: 392 consecutive patients who underwent MVA or subvalvular sparing MVR for treatment of severe CIMR were retrospectively reviewed...
March 23, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29534164/evolution-of-secondary-mitral-regurgitation
#6
Philipp E Bartko, Noemi Pavo, Ana Pérez-Serradilla, Henrike Arfsten, Stephanie Neuhold, Raphael Wurm, Irene M Lang, Guido Strunk, Jacob P Dal-Bianco, Robert A Levine, Martin Hülsmann, Georg Goliasch
Aims: Secondary mitral regurgitation (MR) drives adverse remodelling towards late heart failure stages. Little is known about the evolution of MR under guideline-directed therapy (GDT) and its relation to cardiac remodelling and outcome. We therefore aimed to assess incidence, impact, and predictors of progressive secondary MR in patients under GDT. Methods and results: We prospectively enrolled 249 patients with chronic heart failure and reduced ejection fraction receiving GDT in this long-term observational study...
March 9, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29524077/evaluation-of-mitral-regurgitation-by-an-integrated-2d-echocardiographic-approach-in-patients-undergoing-transcatheter-aortic-valve-replacement
#7
R Jansen, A M Wind, M J Cramer, F Nijhoff, P Agostoni, F Z Ramjankhan, W J Suyker, P R Stella, S A J Chamuleau
The purpose of this study was to evaluate mitral regurgitation (MR) severity in patients undergoing transcatheter aortic valve replacement (TAVR) by standardized assessment of two-dimensional (2D) transthoracic echocardiography (TTE) and 1-year echocardiographic and clinical outcomes. Pre- and post-procedural TTE's of patients undergoing TAVR between 2008 and 2014 were analyzed. MR was graded according to current guidelines with a systematic and integrated approach. Longitudinal echocardiographic and clinical results were analyzed...
March 10, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29478744/tricuspid-annulus-diameter-does-not-predict-the-development-of-tricuspid-regurgitation-after-mitral-valve-repair-for-mitral-regurgitation-due-to-degenerative-diseases
#8
Tirone E David, Carolyn M David, Cedric Manlhiot
BACKGROUND: Heart valve surgery guidelines suggest that tricuspid valve annuloplasty may be beneficial in patients with a tricuspid annulus (TA) ≥40 mm even in the absence of functional tricuspid regurgitation (TR) at the time of surgery for left-sided valve lesions (class 2a). Given the broad spectrum of degenerative diseases that affect the atrioventricular valves, we hypothesize that this measurement might not be predictive of TR after mitral valve (MV) repair. METHODS: The diameter of the TA was measured preoperatively in a cohort of 312 consecutive patients who had isolated MV repair for degenerative diseases...
February 1, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29367688/mitral-valve-annuloplasty-versus-replacement-for-severe-ischemic-mitral-regurgitation
#9
Baotong Li, Shanglin Chen, Hansong Sun, Jianping Xu, Yunhu Song, Wei Wang, Shuiyun Wang
Although practice guidelines recommend surgery for patients with severe chronic ischemic mitral regurgitation (CIMR), they do not specify whether to repair or replace the mitral valve. 436 consecutive patients with severe CIMR were eligible for inclusion in the study, of which 316 (72.5%) underwent mitral valve annuloplasty (MVA) whereas 120 (27.5%) received mitral valve replacement (MVR). At 59 months (interquartile range, 37-85 months) follow-up, though the left ventricle end-diastolic diameter was markedly larger (P = 0...
January 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#10
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
February 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29300869/educational-needs-and-application-of-guidelines-in-the-management-of-patients-with-mitral-regurgitation-a-european-mixed-methods-study
#11
Bernard Iung, Victoria Delgado, Patrice Lazure, Suzanne Murray, Per Anton Sirnes, Raphael Rosenhek, Susanna Price, Marco Metra, Céline Carrera, Michele De Bonis, Michael Haude, Gerhard Hindricks, Jeroen Bax, Alec Vahanian
Aims: To assess the knowledge and application of European Society of Cardiology (ESC) Guidelines in the management of mitral regurgitation (MR). Methods and results: A mixed-methods educational needs assessment was performed. Following a qualitative phase (interviews), an online survey was undertaken using three case scenarios (asymptomatic severe primary MR, symptomatic severe primary MR in the elderly, and severe secondary MR) in 115 primary care physicians (PCPs), and 439 cardiologists or cardiac surgeons from seven European countries...
January 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29291344/diagnosis-and-management-of-ischemic-mitral-regurgitation-evidence-based-clinical-decision-making-at-the-point-of-care
#12
Ajay Kumar Jha, Vishwas Malik
Anatomical, functional, and pathophysiologic mechanisms of ischemic mitral regurgitation (IMR) are markedly different from the primary mitral regurgitation. The older and ubiquitous cutoff of EROA (effective regurgitant orifice area) and Rvol (regurgitant volume) for IMR has been reinstated in the new guideline after a brief hiatus. There had always been a lack of good-quality evidence for its introduction for guiding IMR severity in the previous guideline, and we still do not have quality evidences that could justify its reintroduction...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29277857/percutaneous-mitral-valve-interventions-and-heart-failure
#13
Abhishek Sharma, Sunny Goel, Sahil Agarwal
Mitral regurgitation (MR) is the most frequent Valvular Heart Disease (VHD) and is an important cause of heart failure. MR can be caused by primary valve abnormality (Degenerative MR/Primary MR) or it can be secondary to cardiomyopathy (Functional MR/Secondary MR). Medical management alleviates symptoms but does not alter the progression of the disease. Current guidelines recommend surgery for moderate-to-severe (Grade > 3) MR in patients with symptoms or evidence of left ventricular dysfunction. Despite current practice guidelines, the majority of patients with severe MR do not undergo surgery...
December 27, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29236990/outcome-reporting-for-surgical-treatment-of-degenerative-mitral-valve-disease-a-systematic-review-and-critical-appraisal
#14
Anton Tomšic, Bardia Arabkhani, Jan W Schoones, Thomas J van Brakel, Johanna J M Takkenberg, Meindert Palmen, Robert J M Klautz
OBJECTIVES: Standardized outcome reporting is of critical importance for performance monitoring, improvement of existing techniques and introduction of novel technologies. Whether outcome reporting for surgical treatment of degenerative mitral valve disease complies with the guidelines has not been assessed to date. METHODS: A systematic review of PubMed, EMBASE, Web of Science and the Cochrane Library was conducted for articles published between 1 January 2009 and 7 March 2016...
December 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#15
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
March 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29206746/mitral-valve-and-subvalvular-repair-for-secondary-mitral-regurgitation-rationale-and-clinical-outcomes-of-the-papillary-muscle-sling
#16
Christos G Mihos, Romain Capoulade, Evin Yucel, Steve Xydas, Francesco Nappi, Roy F Williams, Orlando Santana
Secondary mitral regurgitation (MR) is a common finding in patients with dilated cardiomyopathy, and it is associated with poor outcomes. It is the result of incomplete systolic closure of the mitral valve (MV) as a consequence of left ventricular dilatation, papillary muscle displacement with impaired systolic shortening, and mitral leaflet tethering. MV surgery may be performed in cases of significant secondary MR despite guideline-directed medical therapy. However, MV repair, which is most commonly performed with an undersized ring annuloplasty, is associated with a 30-60% recurrence of moderate or greater MR at mid-term follow-up...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29166877/a-prospective-study-examining-the-role-of-myocardial-fibrosis-in-outcome-following-mitral-valve-repair-in-degenerative-mitral-regurgitation-rationale-and-design-of-the-mitral-finder-study
#17
Boyang Liu, Nicola C Edwards, Desley A H Neal, Christopher Weston, Gerard Nash, Nicolas Nikolaidis, Thomas Barker, Ramesh Patel, Moninder Bhabra, Richard P Steeds
BACKGROUND: The optimal management of chronic severe primary degenerative mitral regurgitation (MR) is to repair the valve but identification of the optimal timing of surgery remains challenging. Current guidelines suggest 'watchful waiting' until the onset of symptoms or left ventricular (LV) dysfunction but these have been challenged as promoting 'rescue surgery'. Better predictors are required to inform decision-making in relation to the necessity and timing of surgery. Chronic volume overload is a stimulus for adverse adaptive LV remodelling...
November 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29128265/atrial-appendage-thrombosis-risk-is-lower-for-atrial-flutter-compared-with-atrial-fibrillation
#18
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. However, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography, thereby possibly leading to a lower stroke risk. METHODS: A retrospective review of 2225 patients undergoing transesophageal echocardiography was performed...
April 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29111121/invasive-validation-of-the-echocardiographic-assessment-of-left-ventricular-filling-pressures-using-the-2016-diastolic-guidelines-head-to-head-comparison-with-the-2009-guidelines
#19
Bhavna Balaney, Diego Medvedofsky, Anuj Mediratta, Amita Singh, Boguslawa Ciszek, Eric Kruse, Atman P Shah, Karima Addetia, Roberto M Lang, Victor Mor-Avi
BACKGROUND: Recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines for echocardiographic evaluation of left ventricular (LV) diastolic function provide a practical, simplified diagnostic algorithm for estimating LV filling pressure. The aim of this study was to test the accuracy of this algorithm against invasively measured pressures and compare it with the accuracy of the previous 2009 guidelines in the same patient cohort...
January 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29106577/pacing-for-hypertrophic-obstructive-cardiomyopathy-an-update-and-future-directions
#20
Claude Daubert, Fredrik Gadler, Philippe Mabo, Cecilia Linde
In hypertrophic cardiomyopathy (HCM) patients with symptoms caused by left ventricular outflow tract obstruction (LVOTO), treatment options include negative inotropic drugs, myectomy, septal alcohol ablation and AV sequential pacing with or without an implantable cardioverter defibrillator (ICD). Pacing is rarely used in spite of its relative simplicity and promising results. In this review the current evidence of AV sequential pacing from observational, randomised studies and long and very long-term follow-up studies is given and put in the context of present guidelines recommendations...
June 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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