Key result
Surgical and transcatheter mitral valve advances highlight early surgery for degenerative disease and refined devices.
This review summarizes key updates in the surgical and transcatheter management of mitral valve disease, including the 2014 AHA/ACC guidelines and emerging evidence for early intervention and MitraClip.
Updated guidelines and device refinements warrant clinician awareness; leaves open need for randomized validation of early surgery and transcatheter refinements.
PURPOSE OF REVIEW: In the past year, there has been progress on several fronts in the field of mitral valve surgery and intervention. Here, we review key publications regarding the surgical and transcatheter management of mitral valve disease. RECENT FINDINGS: This past year heralded the publication of the 2014 American Heart Association (AHA)/American College of Cardiology (ACC) Guidelines for the Management of Patients With Valvular Heart Disease. Regarding degenerative mitral regurgitation, low risk of operative mortality and data demonstrating clinical benefit for early surgery are prompting renewed calls for early intervention before guideline-based triggers. For functional mitral regurgitation, the precise roles of chordal-sparing replacement versus repair and the optimal management of moderate disease at the time of surgical revascularization are unclear. Sternal-sparing minimally invasive mitral valve surgery has become a mature procedure in experienced centers and offers comparable surgical morbidity and mortality with superior cosmesis and faster return to baseline function. Transcatheter interventions for mitral regurgitation continue to undergo development and testing. Mounting experience and ongoing clinical trials with the MitraClip endovascular edge-to-edge repair device will provide important data on the optimal target population for this device. SUMMARY: This past year has seen important advances in the surgical treatment of degenerative and functional mitral regurgitation as well as continued refinement of transcatheter interventions.
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Yanagawa et al. (2016) conducted a review in Mitral valve disease. Surgical and transcatheter management was evaluated. Surgical and transcatheter management of mitral valve disease have seen important advances, including renewed calls for early surgery in degenerative disease and refinement of transcatheter devices.
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