Clinical manifestations, diagnosis, and treatment of ischemic mitral regurgitation: a review

Abstract

Ischemic mitral regurgitation (IMR) is a subtype of secondary MR, which is caused as a complication of ischemic heart disease. Valvular involvement can be primary (organic) or secondary (functional). Primary IMR happens after the rupture of the mitral subvalvular apparatus in the context of an acute myocardial infarction (AMI).Secondary IMR occurs when the valve leaflets and chordae are structurally normal and MR results from an imbalance between closing and tethering forces on the mitral valve (MV) secondary to alterations in the left ventricular (LV) geometry (1,2). In both cases, IMR is associated

Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients With Acute Myocardial Infarction

“…There are 5 main reasons for increased PASP 16 : pulmonary hypertension (PH), left heart disease, chronic lung disease, hypoxia, and chronic thromboembolic disease. One more reason for elevated PASP level is ischemic mitral regurgitation, 17 which was a common complication after AMI and was often associated with poor prognosis. 18…”

Mitral valve disease: A view on pathophysiology and management of the most common valve disease in the world

“…Conversely, mechanical valves are believed to be more resilient as multiple studies report a much lower mortality rate, despite the need for anticoagulation therapy. 31,53,54 The same studies, however, highlighted the worryingly high rates of complications and postoperative mortality. Systematic reviews place the mortality rate anywhere between 10 to 60% after one year, while the risk of developing heart failure can be as high as 31%.…”

“…Systematic reviews place the mortality rate anywhere between 10 to 60% after one year, while the risk of developing heart failure can be as high as 31%. 49,51,53,55 Tendyne prosthesis (Abbott Structural, Santa Clara the US) is the first TMVR device to gain CE approval in January 2020, but the evolution of TMVR systems is far from rapid, due to the strict selection criteria of ongoing clinical trials, which affect results by diminishing the external validity of the studies and their transferability to real-life clinical scenarios . 49,51 Minimally Invasive Surgery Surgical mitral valve repair is the gold standard for treating primary MR and around 95% of patients being treated in designated centres while the remaining 5% who are not suited for surgery, will be considered for one of the aforementioned transcatheter interventions.…”

Commentary: Mitral bioprosthesis versus mechanical prosthesis in severe chronic mitral regurgitation: Bioprosthesis wins the duel

“…3,4 MV replacement may offer greater freedom from mitral regurgitation recurrence compared with MV repair in the long-term 5 ; on the opposite side, the adverse effects of implanting a prosthetic valve are fully recognized and may negatively influence mid-and long-term survival. However, because CIMR is a consequence of left ventricle (LV) disease, in some conditions, such as severe LV remodeling, increased tenting area (>2.5 cm 2 ) and coaptation distance (>1 cm), 6 or an increased preoperative posterior leaflet tethering angle (>22 ), 7 MV replacement is preferred or strongly recommend. In this contest, the choice of the prosthetic valve is crucial.…”