Minimally invasive percutaneous transcatheter interventions are being developed as an optimal alternative to open surgery for high-risk patients with chronic heart failure and secondary mitral regurgitation.
Warrants monitoring transcatheter advancements in high-risk HF with secondary MR; leaves open comparative efficacy versus surgery pending RCTs.
Mitral regurgitation (MR) is one of the most common valvular lesions. Severe mitral insufficiency impairs prognosis and quality of life in patients with chronic heart failure (CHF). It is generally accepted to divide MR into primary and secondary. Primary MR develops due to valve degeneration. CHF patients are more likely to develop secondary MR caused by abnormal LV geometry despite intact structure of the valve. Optimal drug therapy of CHF cannot fully affect the processes of reverse remodeling due to fast progression of MR. The main method of treating MR is surgical correction (replacement or repair). However, risk of surgery in most cases is very high due to advanced age of patients with CHF and comorbidities. At the moment, minimally invasive correction of MR is being developed including percutaneous transcatheter interventions as optimal alternative to open interventions.
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Karamova et al. (2024) studied this question.
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