Abstract
Mitral regurgitation (MR) is the most frequent valvular heart disease in developed countries. MR can be organic or functional. The natural history of severe MR is unfavorable, leading to worsening left ventricular failure, pulmonary hypertension, atrial fibrillation, and death. The most common etiology of organic MR in Western countries is degenerative MR due to leaflet tissue alteration known as myxomatous degeneration or fibroelastic deficiency, leading to mitral valve (MV) prolapse or flail. Secondary MR is the consequence of LV dysfunction and dilation due to the maladaptive process in the context of a post-ischemic or idiopathic dilated cardiomyopathy.
Surgical repair represents the optimal treatment for severe degenerative MR and if performed before the onset of limiting symptoms or the development of LV dysfunction, MV repair is able to restore normal life expectancy and quality of life. By contrast, surgical correction of functional MR (FMR) is controversial and outcomes remain sub-optimal in many cases, and perioperative mortality is not negligible.
Over the past few years, new trans-catheter techniques have been developed to treat MR with less invasive approaches. Different types of trans-catheter procedures are becoming available. Currently, the procedure with the widest clinical experience is the percutaneous edge-to-edge performed with the MitraClip System (Abbott Park, IL, USA).
Primary and secondary MR are very different entities in terms of etiology, prognosis, and management and they will therefore be discussed separately in this chapter.
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Taramasso, M., Pozzoli, A., Colombo, A. (2015). Clinical Results of the Percutaneous Edge-to-Edge Repair: Lights and Shadows. In: Alfieri, O., De Bonis, M., La Canna, G. (eds) Edge-to-Edge Mitral Repair. Springer, Cham. https://doi.org/10.1007/978-3-319-19893-4_14
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DOI: https://doi.org/10.1007/978-3-319-19893-4_14
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