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JACC. Case Reports Oct 2023
PubMed: 37954956
DOI: 10.1016/j.jaccas.2023.101979 -
Echo Research and Practice Sep 2021Mitral valve disease is common. Mitral regurgitation is the second most frequent indication for valve surgery in Europe and despite the decline of rheumatic fever in...
Mitral valve disease is common. Mitral regurgitation is the second most frequent indication for valve surgery in Europe and despite the decline of rheumatic fever in Western societies, mitral stenosis of any aetiology is a regular finding in all echo departments. Mitral valve disease is, therefore, one of the most common pathologies encountered by echocardiographers, as both a primary indication for echocardiography and a secondary finding when investigating other cardiovascular disease processes. Transthoracic, transoesophageal and exercise stress echocardiography play a crucial role in the assessment of mitral valve disease and are essential to identifying the aetiology, mechanism and severity of disease, and for helping to determine the appropriate timing and method of intervention. This guideline from the British Society of Echocardiography (BSE) describes the assessment of mitral regurgitation and mitral stenosis, and replaces previous BSE guidelines that describe the echocardiographic assessment of mitral anatomy prior to mitral valve repair surgery and percutaneous mitral valvuloplasty. It provides a comprehensive description of the imaging techniques (and their limitations) employed in the assessment of mitral valve disease. It describes a step-wise approach to identifying: aetiology and mechanism, disease severity, reparability and secondary effects on chamber geometry, function and pressures. Advanced echocardiographic techniques are described for both transthoracic and transoesophageal modalities, including TOE and exercise testing.
PubMed: 34061768
DOI: 10.1530/ERP-20-0034 -
Journal of the American Heart... Jul 2019See Article Desnos et al.
See Article Desnos et al.
Topics: Balloon Valvuloplasty; Cardiac Surgical Procedures; Follow-Up Studies; Humans; Mitral Valve Stenosis
PubMed: 31256697
DOI: 10.1161/JAHA.119.012898 -
Revue Medicale de LiegeAfter aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is...
After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral regurgitation. In case of high or prohibitive surgical risk, new techniques are developed to allow percutaneous, less invasive management. In these circumstances, MitraClip® allows the treatment of mitral regurgitation in case of adequate valve morphology. Percutaneous balloon valvuloplasty is currently the first-line treatment of mitral stenosis related to rheumatic disease when anatomical features are favourable. Alongside the Inoue technique, which remains the classical procedure, other approaches are available with encouraging results.
Topics: Aortic Valve; Catheterization; Humans; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Stenosis
PubMed: 31070320
DOI: No ID Found -
The Journal of Thoracic and... May 2020
Topics: Heart Valve Prosthesis; Humans; Mitral Valve Annuloplasty; Mitral Valve Stenosis
PubMed: 31256957
DOI: 10.1016/j.jtcvs.2019.05.022 -
JACC. Cardiovascular Imaging Jun 2018The mitral valve (MV) is a complex and intricate structure. With the development of transesophageal echocardiography in the 1990s, it became possible to evaluate MV... (Review)
Review
The mitral valve (MV) is a complex and intricate structure. With the development of transesophageal echocardiography in the 1990s, it became possible to evaluate MV anatomy and function in real time during surgical procedures. Subsequently, new surgical and percutaneous techniques for MV repair as well as replacement have evolved. Development of 3-dimensional and intracardiac echocardiography, as well as computed tomography, cardiac resonance imaging, and most recently fusion imaging, have paved the way for a more comprehensive evaluation of the MV as well as for the planning of percutaneous MV procedures such as balloon valvuloplasty, paravalvular mitral leak closure, percutaneous edge-to-edge repair, transcatheter MV annuloplasty, artificial chord implantation, and transcatheter MV replacement. The applicability and use of the various imaging modalities for the assessment and guidance of therapy for MV disorders is discussed in this paper.
Topics: Balloon Valvuloplasty; Cardiac Catheterization; Cardiac Imaging Techniques; Clinical Decision-Making; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Mitral Valve; Mitral Valve Annuloplasty; Multimodal Imaging; Patient Selection; Predictive Value of Tests; Prognosis
PubMed: 29880112
DOI: 10.1016/j.jcmg.2018.02.024 -
Current Treatment Options in... Mar 2017Mitral valve disease represented by mitral stenosis and mitral regurgitation is the second most frequent valvulopathy. Mitral stenosis leads to an increased left atrial... (Review)
Review
Mitral valve disease represented by mitral stenosis and mitral regurgitation is the second most frequent valvulopathy. Mitral stenosis leads to an increased left atrial pressure whereas mitral regurgitation leads to an increased left atrial pressure associated with a volume overload. Secondary to an upstream transmission of this overpressure, both mitral stenosis and regurgitation lead to pulmonary hypertension and right heart failure. In addition, mitral regurgitation also leads to left ventricular dilatation and dysfunction with left heart failure. Depending on the anatomy of the valvular and subvalvular apparatus, valve repair (percutaneous mitral commissurotomy for mitral stenosis and valvuloplasty for mitral regurgitation) might be possible. If the anatomy is not favorable, valve replacement by mechanical or biological prosthesis is indicated. Most of the intervention indications are based on clinical symptoms and resting transthoracic echocardiography. Outcomes of patients operated based upon resting echo abnormalities might however not be optimal. Therefore early intervention might be beneficial based upon abnormal exercise testing, which has been demonstrated to more sensitive to identify high-risk patients. In this last decade, especially exercise echocardiography has been found to be a crucial tool in the management of patients with mitral valve disease.
PubMed: 28290006
DOI: 10.1007/s11936-017-0516-8