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The Surgical Clinics of North America Aug 2017Degenerative mitral valve disease causing mitral regurgitation is the most common organic valve pathology and is classified based on leaflet motion. The "French... (Comparative Study)
Comparative Study Review
Degenerative mitral valve disease causing mitral regurgitation is the most common organic valve pathology and is classified based on leaflet motion. The "French correction" mitral valve repair method restores normal valvular anatomy with extensive leaflet resection, chordal manipulation, and rigid annuloplasty. The American correction attempts to restore normal valve function through minimal leaflet resection, flexible annuloplasty, and use of artificial chordae. These differing methods of mitral valve repair reflect an evolution in principles, but both require understanding of the valve pathology and correction of leaflet prolapse and annular dilatation. Adhering to those unifying principles and ensuring that no patient leaves the operating room with significant persistent mitral regurgitation produces durable results and satisfactory patient outcomes.
Topics: Cardiac Surgical Procedures; France; Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; United States
PubMed: 28728720
DOI: 10.1016/j.suc.2017.03.009 -
Journal of the American College of... Nov 2021
Topics: Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Patient Selection
PubMed: 34736562
DOI: 10.1016/j.jacc.2021.08.062 -
Korean Journal of Radiology 2017The role of cardiac computed tomography (CT) for evaluating the mitral valve (MV) has been limited since echocardiography is the main method of evaluation. However,... (Review)
Review
The role of cardiac computed tomography (CT) for evaluating the mitral valve (MV) has been limited since echocardiography is the main method of evaluation. However, recent advances in cardiac CT have enable detailed evaluation of the anatomy and geometry of the MV. We describe assessments of the anatomy and coaptation geometric parameters of normal MVs, and also review repair of diseased/damaged MV. We also discuss pre- and post-surgical imaging of MV pathology using cardiac CT and various CT images. We found that cardiac CT could be used as an alternative imaging modality to echocardiography for pre-operative MV evaluation and to predict clinical outcomes following repair.
Topics: Echocardiography; Heart Valve Diseases; Humans; Mitral Valve; Tomography, X-Ray Computed
PubMed: 28860895
DOI: 10.3348/kjr.2017.18.5.773 -
Journal of the American College of... Aug 2022Mitral annular calcification (MAC) is a common and challenging pathologic condition, especially in the context of an aging society. Surgical mitral valve intervention in... (Review)
Review
Mitral annular calcification (MAC) is a common and challenging pathologic condition, especially in the context of an aging society. Surgical mitral valve intervention in patients with MAC is difficult, with varying approaches to the calcified annular anatomy, and the advent of transcatheter valve interventions has provided additional treatment options. Advanced imaging provides the foundation for heart team discussions and management decisions concerning individual patients. This review focuses on the prognosis of, preoperative planning for, and management strategies for patients with MAC.
Topics: Calcinosis; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Mitral Valve; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 35953138
DOI: 10.1016/j.jacc.2022.06.009 -
JACC. Cardiovascular Imaging May 2022
Topics: Humans; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Prolapse; Predictive Value of Tests
PubMed: 35131204
DOI: 10.1016/j.jcmg.2022.01.011 -
Cardiology 2020Degenerative mitral valve (MV) disease causing mitral regurgitation (MR) is the most common organic valve pathology and is classified based on leaflet motion. MV repair... (Review)
Review
BACKGROUND
Degenerative mitral valve (MV) disease causing mitral regurgitation (MR) is the most common organic valve pathology and is classified based on leaflet motion. MV repair is indicated as the preferred technique (Class I indication) when the results are expected to be durable. Therefore, a detailed and systematic evaluation of MV apparatus is pivotal in allowing the proper surgical planning, as well as the screening for trans catheter-based treatment when surgery is not indicated.
AIM
The aim of the present review is to describe the crucial role of both Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE) in the decisional process and the guidance of MV repair procedures. TTE is the main investigation and the first approach used to make diagnosis of MR, to assess the severity and to describe the underlying mechanism, while TEE, especially with 3D echocardiography, has been shown to be useful for clarifying complicated valvular anatomy, assessing the surgical result and detecting complications. The surgical treatment of MR takes advantage of ultrasound evaluation of MV apparatus at any stage of the process, thus making the link between surgery and echocardiography unbreakable throughout the perioperative phase.
Topics: Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Humans; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Prolapse
PubMed: 31794963
DOI: 10.1159/000504248 -
Bioprosthetic Mitral Valve Thrombosis: A Multifaceted and Challenging Clinical and Imaging Spectrum.JACC. Cardiovascular Imaging Jul 2022
Topics: Bioprosthesis; Heart Valve Prosthesis; Humans; Mitral Valve; Predictive Value of Tests; Prosthesis Failure; Thrombosis
PubMed: 34801453
DOI: 10.1016/j.jcmg.2021.08.023 -
Journal of Anatomy Aug 2020The mitral valve is a complex anatomical structure whose physiological functioning relies on the biomechanical properties and structural integrity of its components.... (Review)
Review
The mitral valve is a complex anatomical structure whose physiological functioning relies on the biomechanical properties and structural integrity of its components. Their compromise can lead to mitral valve dysfunction, associated with morbidity and mortality. Therefore, a review on the morphometry of the mitral valve is crucial, more specifically on the importance of valve dimensions and shape for its function. This review initially provides a brief background on the anatomy and physiology of the mitral valve, followed by an analysis of the morphological information available. A characterisation of mathematical descriptions of several parts of the valve is performed and the impact of different dimensions and shape changes in disease is then outlined. Finally, a section regarding future directions and recommendations for the use of morphometric information in clinical analysis of the mitral valve is presented.
Topics: Biomechanical Phenomena; Humans; Mitral Valve; Models, Anatomic
PubMed: 32242929
DOI: 10.1111/joa.13196 -
Current Cardiology Reports Jul 2021We aimed to picture the contemporary landscape of available catheter-based repair and replacement solutions for mitral regurgitation (MR) in Europe. (Review)
Review
PURPOSE OF REVIEW
We aimed to picture the contemporary landscape of available catheter-based repair and replacement solutions for mitral regurgitation (MR) in Europe.
RECENT FINDINGS
Edge-to-edge repair remains the dominant technique for transcatheter mitral valve repair especially in the context of secondary mitral regurgitation. Two recent randomized trials reported seemingly contradicting clinical results with transcatheter edge-to-edge repair for patients with heart failure and severe secondary MR. A proportionality framework related to secondary MR was proposed to help explain inconsistencies but requires further research. (In)Direct annuloplasty primarily aims to correct secondary MR; however, the scientific basis seems less robust. One dedicated transcatheter heart valve has the CE mark for mitral valve replacement but requires transapical access. Balloon-expandable transcatheter aortic valve platforms are emerging for transvenous transseptal mitral replacement in the context of mitral annular calcification, a failing surgical mitral bioprosthesis, or annuloplasty. Advanced computed tomography imaging techniques improved pre-procedural planning and introduced the option for modeling and simulation. Development of a toolbox of catheter-based technologies, complementary imaging modalities, and refined patient selection offer novel perspectives to high-risk patients with primary or secondary MR. Clinical trials are required to help formulate evidence-based guidelines for the management of mitral valve disease.
Topics: Cardiac Catheterization; Europe; Heart Valve Prosthesis Implantation; Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 34269914
DOI: 10.1007/s11886-021-01556-6 -
Journal of the American College of... Dec 2021
Topics: Heart Valve Prosthesis Implantation; Humans; Mitral Valve; Mitral Valve Insufficiency
PubMed: 34886962
DOI: 10.1016/j.jacc.2021.10.010