Mitral regurgitation: lessons learned from COAPT and MITRA-Fr

Nappi, Francesco; Nenna, Antonio; Sing, Sanjeet Singh Avvtar; Timofeeva, Irina; Mihos, Christos G.; Gentile, Federico; Chello, Massimo

doi:10.21037/jtd.2020.01.67

Cited by 8 publications

(12 citation statements)

References 71 publications

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“…The use of the MitraClip procedure is recommended in patients with disproportionate secondary mitral regurgitation in which severe MR is coupled with nonseverely dilated left ventricular chambers [95,96]. Although this new framework is a very attractive proposal, however, it does not find unanimous consensus and requires further deep investigation involving transcatheter heart valve therapy [113][114][115][116][117][118][119][120][121][122][123][124][125][126][127].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Nappi

Singh

Bellomo

et al. 2021

BioMed Research International

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Background. Mitral valve disease surgery is an evolving field with multiple possible interventions. There is an increasing body of evidence regarding the optimal strategy in secondary mitral regurgitation where the pathology lies within the ventricle. We conducted a systematic review to identify the benefits and limitations of each surgical option. Methods. A systematic review of the literature was performed to identify pertinent randomized controlled trials (RCTs), propensity-matched observational series, and meta-analyses which were considered initially and followed by unmatched observational series using the MEDLINE, Ovid EMBASE, and Cochrane Library. Results. We identified 6 different strategies for treating secondary mitral valve regurgitation: mitral valve replacement, restrictive mitral annuloplasty, surgical revascularization (with and without mitral annuloplasty), subvalvular procedures (papillary muscle approximation, papillary muscle relocation, ring and string procedure), and procedures directly targeting the mitral valve (edge-to-edge repair and anterior leaflet enlargement) alongside transcatheter heart valve therapy. We also highlighted the role of left ventricular assist devices in the management of this condition. The benefits and limitations of each intervention are highlighted. Conclusion. There is currently no unanimous and shared strategy for the optimal treatment of patients with secondary IMR. The management of patients with secondary mitral regurgitation must be entrusted to a multidisciplinary Heart Team to ensure ideal intervention and patient matching for the best outcomes.

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Section: Discussionmentioning

confidence: 99%

Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Nappi

Singh

Bellomo

et al. 2021

BioMed Research International

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“…Both procedures had the same enrollment method for the patients who were considered suitable for the use of devices, therefore 349 persons from 98 sites were included in the US registry from 2013 to 2015 [26] . Nevertheless, the recent literature shows that the transcatheter procedure with the use of Mitraclip has a slight advantage over TMViV-T due to a better understanding of the pathophysiology of mitral rigurgitation and the normalization of the geometry [2][3][4]8,9,[27][28][29][30] .…”

Section: The Emerging New Contribution Of Transcatheter Mitral Valve-in-valve Therapymentioning

confidence: 99%

“…The increase in the number of mitral valve repair operations, with a rise in the number of biological prostheses implanted in younger patients, has resulted in higher incidences of reoperative mitral valve surgery. Bioprosthesis replacement for deterioration or failed repairs and mitral annular calcification (MAC) pose ongoing challenges to the surgical management of patients requiring repeat valve surgery (Re-MVS) [1][2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Transcatheter valve-in-valve implantation vs. reoperative mitral valve surgery for failing surgical prosthesis

Nappi¹,

Verghi²,

Singh³

et al. 2021

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“…The ischemic injury of PPMs causes impairment of its contractile function and a reduction in systolic shortening (PPMs dysfunction) and may be related to MVR, especially when the ventricular function is compromised, resulting in poorer prognosis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Papillary Muscle Involvement during Acute Myocardial Infarction: Detection by Cardiovascular Magnetic Resonance Using T1 Mapping Technique and Papillary Longitudinal Strain

Pambianchi

Giannetti

Marchitelli

et al. 2023

JCM

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Papillary muscle (PPM) involvement in myocardial infarction (MI) increases the risk of secondary mitral valve regurgitation or PPM rupture and may be diagnosed using late gadolinium enhancement (LGE) imaging. The native T1-mapping (nT1) technique and PPM longitudinal strain (PPM-ls) have been used to identify PPM infarction (iPPM) without the use of the contrast agent. This study aimed to assess the diagnostic performance of nT1 and PPM-ls in the identification of iPPM. Forty-six patients, who performed CMR within 14–30 days after MI, were retrospectively enrolled: sixteen showed signs of iPPM on LGE images. nT1 values were measured within the infarcted area (IA), remote myocardium (RM), blood pool (BP), and anterolateral and posteromedial PPMs and compared using ANOVA. PPM-ls values have been assessed on cineMR images as the percentage of shortening between end-diastolic and end-systolic phases. Higher nT1 values and lower PPM-ls were found in infarcted compared to non-infarcted PPMs (nT1: 1219.3 ± 102.5 ms vs. 1052.2 ± 80.5 ms and 17.6 ± 6.3% vs. 21.6 ± 4.3%; p-value < 0.001 for both), with no significant differences between the nT1 of infarcted PPMs and IA and between the non-infarcted PPMs and RM. ROC analysis demonstrated an excellent discriminatory power for nT1 in detecting the iPPM (AUC = 0.874; 95% CI: 0.784–0.963; p < 0.001). nT1 and PPM-ls are valid tools in assessing iPPM with the advantage of avoiding contrast media administration.

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Mitral regurgitation: lessons learned from COAPT and MITRA-Fr

Cited by 8 publications

References 71 publications

Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Transcatheter valve-in-valve implantation vs. reoperative mitral valve surgery for failing surgical prosthesis

Papillary Muscle Involvement during Acute Myocardial Infarction: Detection by Cardiovascular Magnetic Resonance Using T1 Mapping Technique and Papillary Longitudinal Strain

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