Percutaneous and Surgical Treatment of Mitral Valve Regurgitation

Seeburger, Joerg; Katus, Hugo A.; Pleger, Sven T.; Krumsdorf, Ulrike; Mohr, Friedrich-Wilhelm; Bekeredjian, Raffi
December 2011
Deutsches Aerzteblatt International;12/2/2011, Vol. 108 Issue 48, preceding p816
Academic Journal
Background: Mitral valve regurgitation is the second most common clinically relevant valvular heart disease in adults, with an incidence of about 2% to 3% per year. Surgical mitral valve repair is the treatment of choice. Recent years have seen major advances in minimally invasive mitral valve surgery. Several new catheter-based techniques are now being clinically evaluated, including percutaneous endovascular mitral valve repair with a mitral clip. Method: This review is based on a selective review of the literature and on the authors' clinical experience. Results: Minimally invasive and reconstructive techniques for mitral valve surgery have come into more common use in recent years. In Germany, more than 50% of all mitral valve defects are now treated with a valve-preserving repair procedure. At the same time, percutaneous techniques have been developed that enable reduction of mitral regurgitation in the cardiac catheterization laboratory, without surgery. The implantation of a mitral clip is the sole currently approved technique of this type. In a recently published, randomized comparative clinical trial (EVEREST II), it was found to be safer, but less effective, than surgery. Conclusion: Mitral valve surgery remains the treatment of choice for severe mitral regurgitation. For patients at high risk from surgery, and particularly those with severe heart failure, the implantation of a mitral clip is a safe and feasible treatment option.


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