Topics:
Valvular Heart Diseases
Session number: 361
Session title: Difficult clinical decisions: the experts'views on managing mitral insufficiency and aortic stenosis
Authors: THOMAS James D. (Cleveland, US)
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Mitral regurgitation is a common cause of cardiac disability, both as a primary disorder (most commonly myxomatous mitral regurgitation) and secondary to other conditions, such as ischemic cardiomyopathy. Assessment begins with a careful assessment of valvular and subvalvular structure and function, and here three-dimensional echocardiography can play a critical role. Regurgitant quantitation is critical, and we analyze the proximal convergence zone by color Doppler echocardiography to measure the regurgitant orifice area. Decisions for intervention are based on the presence of symptoms, left ventricular dysfunction, and the degree of coronary artery disease. Exercise echocardiography can assist with decision-making, as the degree of regurgitation often changes with exercise. Other modalities, particularly cardiac magnetic resonance, can play a key adjunctive role in clarifying etiology and indications for surgery.
Teaching objective of the lecture:
As a result of this lecture, the attendee will be able to:
- Describe structural differences between organic and functional mitral regurgitation,
- Measure the mitral regurgitant orifice area by the simplified proximal convergence method,
- Decide when surgery is necessary for mitral regurgitation.
Teaching objective of the lecture:
- Echocardiography (particularly 3D) can precisely characterize the mitral apparatus
- Surgery is indicated when MR causes symptoms or LV dysfunction
- The vast majority of ischemic and organic mitral regurgitation can be repaired at low surgical risk
The content of this article reflects the personal opinion of the
author/s and is not necessarily the official position of the
European Society of Cardiology.