TY - JOUR
T1 - Mitral valve regurgitation
T2 - a disease with a wide spectrum of therapeutic options
AU - Del Forno, Benedetto
AU - De Bonis, Michele
AU - Agricola, Eustachio
AU - Melillo, Francesco
AU - Schiavi, Davide
AU - Castiglioni, Alessandro
AU - Montorfano, Matteo
AU - Alfieri, Ottavio
N1 - Publisher Copyright:
© 2020, Springer Nature Limited.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Over the past two decades interest in mitral valve regurgitation has increased as a result of the development of new technologies that have expanded the number of patients who can potentially benefit from mitral regurgitation treatments. To develop new devices for the treatment of mitral regurgitation, the focus has been placed on the functional anatomy and pathophysiology of the mitral valve, with the use of the most advanced methods of cardiac imaging that allow the best visualization of the mitral valve and a perfect understanding of the complexity of a specific disease. Mitral regurgitation is still underdiagnosed and undertreated in a substantial number of patients who have poor survival. Therefore, the priority should be to identify and treat these patients to increase their survival and quality of life. To achieve this goal, general physicians and cardiologists must be aware of all the treatment options that are currently available in dedicated centres of excellence. Patients referred to these centres can benefit from a tailored heart team-based approach. The aim of this Review is to analyse the basic principles of mitral regurgitation, discussing new concepts on the pathophysiology of the mitral valve that have been developed to facilitate the selection of patients for transcatheter procedures. We also describe the indications and timing of treatment, contemporary surgical and transcatheter techniques and the heart team approach, and highlight the need for centres of excellence.
AB - Over the past two decades interest in mitral valve regurgitation has increased as a result of the development of new technologies that have expanded the number of patients who can potentially benefit from mitral regurgitation treatments. To develop new devices for the treatment of mitral regurgitation, the focus has been placed on the functional anatomy and pathophysiology of the mitral valve, with the use of the most advanced methods of cardiac imaging that allow the best visualization of the mitral valve and a perfect understanding of the complexity of a specific disease. Mitral regurgitation is still underdiagnosed and undertreated in a substantial number of patients who have poor survival. Therefore, the priority should be to identify and treat these patients to increase their survival and quality of life. To achieve this goal, general physicians and cardiologists must be aware of all the treatment options that are currently available in dedicated centres of excellence. Patients referred to these centres can benefit from a tailored heart team-based approach. The aim of this Review is to analyse the basic principles of mitral regurgitation, discussing new concepts on the pathophysiology of the mitral valve that have been developed to facilitate the selection of patients for transcatheter procedures. We also describe the indications and timing of treatment, contemporary surgical and transcatheter techniques and the heart team approach, and highlight the need for centres of excellence.
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U2 - 10.1038/s41569-020-0395-7
DO - 10.1038/s41569-020-0395-7
M3 - Review article
C2 - 32601465
AN - SCOPUS:85087038960
VL - 17
SP - 807
EP - 827
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
SN - 1759-5002
IS - 12
ER -