Minimally invasive mitral valve repair for functional mitral regurgitation

Standard

Minimally invasive mitral valve repair for functional mitral regurgitation. / Girdauskas, Evaldas; Pausch, Jonas; Harmel, Eva; Gross, Tatiana; Detter, Christian; Sinning, Christoph; Kubitz, Jens; Reichenspurner, Hermann.

in: EUR J CARDIO-THORAC, Jahrgang 55, Nr. Suppl 1, 01.06.2019, S. i17-i25.

Publikationen: SCORING: Beitrag in Fachzeitschrift/ZeitungÜbersichtsarbeitenForschung

Harvard

APA

Vancouver

Bibtex

@article{812137a827a642dcbe5bd0b1c9a6d674,
title = "Minimally invasive mitral valve repair for functional mitral regurgitation",
abstract = "Systolic heart failure is frequently accompanied by a relevant functional mitral valve regurgitation (FMR) which develops as a direct sequela of the ongoing left ventricular remodelling. The severity of mitral regurgitation is further aggravated by progressive left ventricular enlargement causing leaflet tethering and reduced systolic leaflet movement. The prognosis of such patients is obviously limited by an underlying left ventricular disease, and the correction of secondary FMR has been previously suggested as predominantly 'cosmetic' surgery in the setting of ongoing cardiomyopathy. Inferior results of an isolated annuloplasty in type IIIb FMR supported the philosophy of malignant course of progressive cardiomyopathy and resulted in increasingly restricted indications for mitral valve surgery for FMR in the guidelines. The lack of a standardized pathophysiological approach to correct type IIIb FMR led to the development of valve replacement strategy and edge-to-edge catheter-based mitral valve procedures, which became the most frequent procedures in the FMR setting in Europe. Modern mitral valve surgery combines the advantages of 3-dimensional endoscopic minimally invasive surgical approach with standardized subannular repair to address the pathophysiological background of type IIIb FMR. The perioperative results have been significantly improved, and there is a growing evidence of improved long-term stability of subannular repair procedures as compared to isolated annuloplasty. This review article aims to present the current state-of-the-art of the modern mitral valve surgery in FMR and provides suggestions for future trials analysing the potential advantages in these patients.",
keywords = "Heart Valve Prosthesis, Humans, Minimally Invasive Surgical Procedures, Mitral Valve Annuloplasty, Mitral Valve Insufficiency/classification, Mitral Valve/physiopathology, Prognosis, Ventricular Remodeling/physiology",
author = "Evaldas Girdauskas and Jonas Pausch and Eva Harmel and Tatiana Gross and Christian Detter and Christoph Sinning and Jens Kubitz and Hermann Reichenspurner",
note = "{\textcopyright} The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.",
year = "2019",
month = jun,
day = "1",
doi = "10.1093/ejcts/ezy344",
language = "English",
volume = "55",
pages = "i17--i25",
journal = "EUR J CARDIO-THORAC",
issn = "1010-7940",
publisher = "Elsevier",
number = "Suppl 1",

}

RIS

TY - JOUR

T1 - Minimally invasive mitral valve repair for functional mitral regurgitation

AU - Girdauskas, Evaldas

AU - Pausch, Jonas

AU - Harmel, Eva

AU - Gross, Tatiana

AU - Detter, Christian

AU - Sinning, Christoph

AU - Kubitz, Jens

AU - Reichenspurner, Hermann

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Systolic heart failure is frequently accompanied by a relevant functional mitral valve regurgitation (FMR) which develops as a direct sequela of the ongoing left ventricular remodelling. The severity of mitral regurgitation is further aggravated by progressive left ventricular enlargement causing leaflet tethering and reduced systolic leaflet movement. The prognosis of such patients is obviously limited by an underlying left ventricular disease, and the correction of secondary FMR has been previously suggested as predominantly 'cosmetic' surgery in the setting of ongoing cardiomyopathy. Inferior results of an isolated annuloplasty in type IIIb FMR supported the philosophy of malignant course of progressive cardiomyopathy and resulted in increasingly restricted indications for mitral valve surgery for FMR in the guidelines. The lack of a standardized pathophysiological approach to correct type IIIb FMR led to the development of valve replacement strategy and edge-to-edge catheter-based mitral valve procedures, which became the most frequent procedures in the FMR setting in Europe. Modern mitral valve surgery combines the advantages of 3-dimensional endoscopic minimally invasive surgical approach with standardized subannular repair to address the pathophysiological background of type IIIb FMR. The perioperative results have been significantly improved, and there is a growing evidence of improved long-term stability of subannular repair procedures as compared to isolated annuloplasty. This review article aims to present the current state-of-the-art of the modern mitral valve surgery in FMR and provides suggestions for future trials analysing the potential advantages in these patients.

AB - Systolic heart failure is frequently accompanied by a relevant functional mitral valve regurgitation (FMR) which develops as a direct sequela of the ongoing left ventricular remodelling. The severity of mitral regurgitation is further aggravated by progressive left ventricular enlargement causing leaflet tethering and reduced systolic leaflet movement. The prognosis of such patients is obviously limited by an underlying left ventricular disease, and the correction of secondary FMR has been previously suggested as predominantly 'cosmetic' surgery in the setting of ongoing cardiomyopathy. Inferior results of an isolated annuloplasty in type IIIb FMR supported the philosophy of malignant course of progressive cardiomyopathy and resulted in increasingly restricted indications for mitral valve surgery for FMR in the guidelines. The lack of a standardized pathophysiological approach to correct type IIIb FMR led to the development of valve replacement strategy and edge-to-edge catheter-based mitral valve procedures, which became the most frequent procedures in the FMR setting in Europe. Modern mitral valve surgery combines the advantages of 3-dimensional endoscopic minimally invasive surgical approach with standardized subannular repair to address the pathophysiological background of type IIIb FMR. The perioperative results have been significantly improved, and there is a growing evidence of improved long-term stability of subannular repair procedures as compared to isolated annuloplasty. This review article aims to present the current state-of-the-art of the modern mitral valve surgery in FMR and provides suggestions for future trials analysing the potential advantages in these patients.

KW - Heart Valve Prosthesis

KW - Humans

KW - Minimally Invasive Surgical Procedures

KW - Mitral Valve Annuloplasty

KW - Mitral Valve Insufficiency/classification

KW - Mitral Valve/physiopathology

KW - Prognosis

KW - Ventricular Remodeling/physiology

U2 - 10.1093/ejcts/ezy344

DO - 10.1093/ejcts/ezy344

M3 - Scientific review articles

C2 - 31106337

VL - 55

SP - i17-i25

JO - EUR J CARDIO-THORAC

JF - EUR J CARDIO-THORAC

SN - 1010-7940

IS - Suppl 1

ER -