Why the study?
Understanding the pathophysiology of specific subgroups of patients with functional mitral regurgitation is key to successfully deploying novel percutaneous devices to those most likely to benefit.
This review highlights the pathophysiology and emerging percutaneous treatment options for secondary mitral regurgitation, emphasizing the importance of patient selection based on specific subgroups.
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May inform subgroup selection for percutaneous secondary MR therapies; leaves optimal strategies open for prospective validation.
Mitral regurgitation is frequently associated with ventricular dysfunction and carries a high mortality. Guideline-directed medical therapy, surgical mitral valve repair or replacement, and, in the setting of advanced heart failure, heart transplant and left ventricular assist devices have been the mainstay of treatment. However, rapid advancement in the field has resulted in approval of edge-to-edge mitral valve repair with the MitraClip, and there are several novel catheter-based percutaneous options in clinical trials. Percutaneous options, while promising, must be deployed in patients who are most likely to benefit, and thus, understanding the pathophysiology of specific subgroups of patients with functional mitral regurgitation (eg, disproportionate versus proportionate mitral regurgitation) is key to the success of new devices. We review the pathophysiology, percutaneous therapeutic treatment options, and ongoing clinical trials for functional mitral regurgitation.
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Ali et al. (2020) studied this question.
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