The review emphasizes the need to address altered ventricular mechanics alongside traditional annuloplasty for the treatment of functional mitral regurgitation.
May inform device-based strategies for functional MR; leaves open prospective trials of combined ventricular and annular repair.
Functional mitral valve regurgitation (MR), a condition affecting millions of primarily elderly patients worldwide, is associated with poor clinical outcomes. Functional MR has traditionally been considered a disorder of regional or global left ventricular (LV) remodeling secondary to myocardial disease, in which anatomically normal leaflets fail to coapt adequately. The primary mechanisms of MR are mitral annular dilatation and leaflet restriction secondary to LV remodeling. Although annuloplasty is commonly used to correct valve incompetence, the effects of altered ventricular mechanics on MR need to be specifically addressed. This review focuses on current concepts of geometric reconfiguration of the LV and mitral-ventricular apparatus to reduce MR.
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Karimov et al. (2012) studied this question.
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