title: Treatment of secondary mitral valve regurgitation: why we need combined and evolving percutaneous strategies to tackle this moving target.
abstract: Secondary mitral regurgitation (MR) has a complex pathophysiology that includes global or segmental left ventricular (LV) motion abnormalities (of non-ischaemic or ischaemic origin) leading to impaired leaflet coaptation of a normally structured mitral valve (MV). In this context, the LV functional and geometrical changes result in MV leaflet tethering, MV annulus flattening and the decrement of systolic MV closing forces. In light of its complexity, management of secondary MR remains a challenge. In fact, a long-lasting successful treatment using a single medical device and/or intervention that addresses solely the MV target cannot, at least at the present time, be proposed.
authors.affiliation: Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany and Rostock University Medical Center, Rostock, Germany.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ancona
authors.forename: Stephan
authors.initials: S
authors.lastname: Kische
authors.forename: Hüseyin U
authors.initials: HU
authors.lastname: Agma
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
mesh_terms: D000465:Algorithms; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019091:Critical Pathways; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D018579:Patient Selection; D011474:Prosthesis Design; D020127:Recovery of Function; D012307:Risk Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left