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MITRAL VALVE DISEASE

Mitral Regurgitation (MR) accounts for the vast majority of all mitral valve diseases.1 It has a prevalence of approximately 2% in the general population and is more common in the elderly population.3 Approximately 10% of people over the age of 70 have clinically meaningful MR.5

If left untreated, MR can lead to Heart Failure (HF), or deterioration of pre-existing HF, resulting in an increased number of hospital admissions and a substantial cost burden to health systems.6,8

MITRAL VALVE DISEASE

Mitral Regurgitation (MR) occurs when the mitral valve leaflets fail to properly close during ventricular contraction (systole) so blood flows back into the left atrium, leading to inefficient pumping of blood around the body.9,18

Primary (e.g. degenerative or organic) Mitral Regurgitation (PMR) is caused by abnormalities in one or more components of the mitral valve architecture, such as the leaflets, chordae, or papillary muscles.10,11

Secondary Mitral Regurgitation (SMR), also referred to as Functional Mitral Regurgitation (FMR), occurs as a result of left ventricle dysfunction, which is typically caused by ischaemic heart disease or dilated cardiomyopathy. In SMR, the mitral valve is in itself normal.10,11

FIND OUT MORE:

Two Types of Mitral Regurgitation

Normal

Primary MR

Secondary MR

1-YEAR MORTALITY UP TO
57%*
Mitral regurgitation, if left untreated, initiates a cascade of events leading to HF and death12-14
*The 1-year mortality rate of 57% was recorded in a subgroup of patients with MR grade 4+.12

TREATMENT OF MR

Treatment of MR is guided by the disease classification (primary/secondary) and severity. In SMR the approach to treatment is also guided by the nature of the patient’s underlying heart disease. The best treatment approach for a given patient and their condition (whether it be PMR or SMR) is determined by a Multidisciplinary Heart Team (MDT).16 Treatment options for MR include medical management, surgical repair or replacement, and Transcatheter Mitral Valve repair (TMVr) or Replacement (TMVR). Transcatheter Edge-to-Edge Repair (TEER) is a minimally invasive TMVr option.

 

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F. Maisano, M. Swaans, M. Adam. M. Weber

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PCRLV 2021: Transcatheter mitral valve replacement

PCRLV 2021: Transcatheter mitral valve replacement: patient selection & hemodynamic stability

EuroEcho 2021: MR Treatment (Patient)

EuroEcho 2021: Tailoring Transcatheter Mitral Regurgitation Treatment: The Patient

ESC 2022: FMR

ESC 2022: How do I manage my patient with functional mitral regurgitation?

EuroEcho 2021: MR Treatment (Evidence)

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EXPAND Study: Data overview

Expand Study: Clinical Outcomes from the Global EXPAND Registry

References
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