MITRAL VALVE PATHOLOGY: CHALLENGES AND SOLUTIONS – A SHORT OVERVIEW
MITRAL VALVE PATHOLOGY: CHALLENGES AND SOLUTIONS – A SHORT OVERVIEW

Author(s): Manferd Marx, Daniel Zimpfer
Contributor(s): Adnan Arnautlija (Translator)
Subject(s): Health and medicine and law
Published by: Akademija Nauka i Umjetnosti Bosne i Hercegovine
Keywords: mitral valve; pathology; challenges;
Summary/Abstract: Mitral valve prolapse (MVP) is the most common valve disease (prevalence of 2 to 3%). Although MVP is generally regarded as a benign condition, complications such as mitral regurgitation, atrial fibrillation, congestive heart failure, endocarditis and stroke are well known. MVP is a significant cause of SCD where CE-CMR (contrast-enhanced MRI) might allow the identification of this arrhythmic substrate. Transcatheter mitral valve interventions are progressively being introduced into clinical practice targeting a population of patients with mitral regurgitation (MR). Beyond percutaneous edge to edge repair (MitraClip®), a percutaneous surgical-like direct annuloplasty device but also transcatheter chordal replacement and indirect annuloplasty (using coronary sinus devices, radiofrequency-mediated annular remodeling and cinching devices) are in various stages of development. Meanwhile, we do have personal experience using Melody valves as MV replacement using the hybrid approach. Rheumatic fever continues to be the commonest cause of acquired heart disease in the children and adolescent population of most developing countries. Until the early 1980s, the only option for patients with mitral stenosis (MS) uncontrollable by medical therapy was surgery. After several technical modifications balloon mitral valvotomy is a standard therapeutic modality for managing rheumatic mitral stenosis. Patients with sinus rhythm, less gross valve deformity, and a post-balloon mitral valvotomy area >1.75 cm2 will have better intermediate outcomes. Detailed knowledge of MV pathology will lead to perfect solutions for each individual patient.

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