“Surgical Treatment of Degenerative Mitral Valve Disease-Causing Mitral Regurgitation: State Of The Art”

2021 ◽  
Vol 8 (07) ◽  
Author(s):  
Md Faisal Talukder
Keyword(s):  
Mitral Valve ◽  
Natural History ◽  
Mitral Regurgitation ◽  
Clinical Outcomes ◽  
Treatment Strategy ◽  
Mitral Valve Disease ◽  
State Of The Art ◽  
Postoperative Mortality ◽  
Valve Disease ◽  
History Of

Degenerative Mitral Valve Disease (DMVD) is common in developed countries that frequently causes mitral regurgitation (MR). The natural history of DMVD is not well demonstrated. Therefore, timely and suitable interventions are the determinant of post-intervention clinical outcomes, life quality, and life expectancy of patients. The severity of MR can be precisely assessed by doppler-echocardiographic imaging. However, no medical management has been proven to be effective in averting the volume overload related sequel of asymptomatic degenerative MR. Therefore, mitral valve surgery (MVS) is the gold standard treatment strategy for DMVD. Notwithstanding, MVS is the only sorts of treatment strategy which provides long term natural and complication-free clinical outcome to otherwise healthy DMVD patients. However, mitral valve (MV) repair provides better clinical outcomes compared to MV replacement, along with the significant reduction of postoperative mortality rate about 70%. Currently, MVS is carried out using minimally invasive techniques or robotic-assisted techniques. Nonetheless, MVS using percutaneous techniques is evolving in the treatment for DMVD patients. This state-of-the-art-review is aimed to delineate the recent knowledge of DMVD, which includes the natural history of the disease, diagnostic modalities, recent treatment strategies, and clinical follow-up results.

scholarly journals Natural history of coexistent tricuspid regurgitation in patients with degenerative mitral valve disease: Implications for future guidelines

2014 ◽  
Vol 148 (6) ◽  
pp. 2802-2810 ◽  
Author(s):  
Andrew B. Goldstone ◽  
Jessica L. Howard ◽  
Jeffrey E. Cohen ◽  
John W. MacArthur ◽  
Pavan Atluri ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Natural History ◽  
Tricuspid Regurgitation ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
History Of

NATURAL HISTORY OF MITRAL ANNULUS CALCIFICATION AND CALCIFIC MITRAL VALVE DISEASE

2021 ◽  
Vol 37 (10) ◽  
pp. S76-S77
Author(s):  
N Willner ◽  
I Burwash ◽  
L Beauchesne ◽  
B Vulesevic ◽  
K Ascah ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Natural History ◽  
Mitral Valve Disease ◽  
Mitral Annulus ◽  
Valve Disease ◽  
Mitral Annulus Calcification ◽  
History Of

scholarly journals Characterization of Degenerative Mitral Valve Disease: Differences between Fibroelastic Deficiency and Barlow’s Disease

2021 ◽  
Vol 8 (2) ◽  
pp. 23
Author(s):  
Aniek L. van Wijngaarden ◽  
Boudewijn P. T. Kruithof ◽  
Tommaso Vinella ◽  
Daniela Q. C. M. Barge-Schaapveld ◽  
Nina Ajmone Marsan
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Disease ◽  
Patient Management ◽  
Valve Disease ◽  
Common Cause ◽  
Barlow’S Disease ◽  
Primary Mitral Regurgitation ◽  
Fibroelastic Deficiency

Degenerative mitral valve disease causing mitral valve prolapse is the most common cause of primary mitral regurgitation, with two distinct phenotypes generally recognized with some major differences, i.e., fibroelastic deficiency (FED) and Barlow’s disease. The aim of this review was to describe the main histological, clinical and echocardiographic features of patients with FED and Barlow’s disease, highlighting the differences in diagnosis, risk stratification and patient management, but also the still significant gaps in understanding the exact pathophysiology of these two phenotypes.

Endothelial microparticles increase in mitral valve disease and impair mitral valve endothelial function

2013 ◽  
Vol 304 (7) ◽  
pp. E695-E702 ◽  
Author(s):  
Hong-Bo Ci ◽  
Zhi-Jun Ou ◽  
Feng-Jun Chang ◽  
Dong-Hong Liu ◽  
Guo-Wei He ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Endothelial Cells ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Disease ◽  
Healthy Subjects ◽  
Heat Shock Protein 90 ◽  
Valve Disease ◽  
No Production ◽  
Endothelial Microparticles

Mitral valve endothelial cells are important for maintaining lifelong mitral valve integrity and function. Plasma endothelial microparticles (EMPs) increased in various pathological conditions related to activation of endothelial cells. However, whether EMPs will increase in mitral valve disease and their relationship remains unclear. Here, 81 patients with mitral valve disease and 45 healthy subjects were analyzed for the generation of EMPs by flow cytometry. Human mitral valve endothelial cells (HMVECs) were treated with EMPs. The phosphorylation of Akt and endothelial nitric oxide synthase (eNOS), the association of eNOS and heat shock protein 90 (HSP90), and the generation of nitric oxide (NO) and superoxide anion (O2˙−) were measured. EMPs were increased significantly in patients with mitral valve disease compared with those in healthy subjects. EMPs were negatively correlated with mitral valve area in patients with isolated mitral stenosis. EMPs were significantly higher in the group with severe mitral regurgitation than those in the group with mild and moderate mitral regurgitation. Furthermore, EMPs were decreased dramatically in both Akt and eNOS phosphorylation and the association of HSP90 with eNOS in HMVECs. EMPs decreased NO production but increased O2˙− generation in HMVECs. Our data demonstrated that EMPs were significantly increased in patients with mitral valve disease. The increase of EMPs can in turn impair HMVEC function by inhibiting the Akt/eNOS-HSP90 signaling pathway. These findings suggest that EMPs may be a therapeutic target for mitral valve disease.

scholarly journals Mitral annulus dynamics in myxomatous mitral valve disease

2021 ◽  
Vol 31 (1) ◽  
pp. 66-75
Author(s):  
Maria-Magdalena Gurzun ◽  
Monica Rosca ◽  
Andreea Calin ◽  
Carmen Beladan ◽  
Marinela Serban ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Valve Disease ◽  
Current Trend ◽  
Mitral Annulus ◽  
Valve Disease ◽  
Valve Repair ◽  
Functional Changes ◽  
Different Types

Myxomatous mitral valve disease (MVD) is a common disorder in which the entire mitral valve apparatus seems to be involved. Mitral valve repair is nowadays the method of choice for the correction of mitral regurgitation but the optimal shape and flexibility of the annuloplasty ring remain controversial. Considering that myxomatous MVD covers a wide spectrum from limited fi bro-elastic deficiency to extensive Barlow disease, we presume that the mitral annulus morphological and functional changes are likely different in different types of myxomatous MVD. We analyze the 3-dimensional geometry and the dynamics of the mitral annulus in 110 patients with significant mitral regurgitation due to different types of myxomatous mitral valve disease and 40 normal subjects using 3D transesophageal echocardiography. The mitral annulus differs in patients with limited MVD, extensive MVD and in normal controls in terms of size, shape, and dynamics. Patients with limited MVD have larger, flatter, dysfunctional and more mobile mitral annulus compared to normal, while patients with extensive MVD have even larger, fl atter and more dysfunctional mitral annulus, with reduced mobility. The non-planar dynamics has different patterns during systole, according to the extension of MV disease. Our data may be important for the appropriate choose of annuloplasty mitral annulus in mitral valve repair, the current trend being to choose the ring according to the underlying pathology.

R-R interval variations influence the degree of mitral regurgitation in dogs with myxomatous mitral valve disease

2014 ◽  
Vol 199 (3) ◽  
pp. 348-354 ◽  
Author(s):  
M.J. Reimann ◽  
J.E. Møller ◽  
J. Häggström ◽  
B. Markussen ◽  
A.E.W. Holen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Disease ◽  
Valve Disease
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