Functional mitral regurgitation: therapeutic strategies for a ventricular disease.
Functional mitral regurgitation is a highly prevalent condition among patients with ischemic and dilated cardiomyopathies. Arising from remodeling of both the mitral valve annulus and the left ventricle, it is associated with high mortality and morbidity. In selected patients, cardiac resynchronization therapy helps to reduce functional mitral regurgitation, but surgical intervention remains the mainstay of therapy when medical therapy for left ventricular dysfunction has been inadequate. It is, however, associated with significant perioperative risks and does not alter long-term mortality. Percutaneous devices, and more recently the Mitraclip in particular, represent a promising alternative that can improve symptoms and ventricular remodeling with significantly lower periprocedural risk.
Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: punnoosl@alum.mit.edu.
Lynn
L
Punnoose
Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, New York.
Daniel
D
Burkhoff
BAROnova, San Francisco, California.
Lian
L
Cunningham
Division of Cardiology, Weill Cornell Medical College, New York, New York.
Evelyn M
EM
Horn
D006348:Cardiac Surgical Procedures / Q000592:standards*; D002311:Cardiomyopathy, Dilated / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
Mitraclip; dilated cardiomyopathy; mitral valve surgery