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Review
. 2017 Mar 31;2017(1):e201703.
doi: 10.21542/gcsp.2017.3.

Primary mitral valve regurgitation: Update and review

Eirini Apostolidou  1 , Andrew D Maslow  2 , Athena Poppas  1
Affiliations
Review

Primary mitral valve regurgitation: Update and review

Eirini Apostolidou et al. Glob Cardiol Sci Pract. .

Abstract

Mitral regurgitation is the second most common valvular disorder requiring surgical intervention worldwide. This review summarizes the current understanding of primary, degenerative mitral regurgitation with respect to etiology, comprehensive assessment, natural history and management. The new concept of staging of the valvular disorders, newer predictors of adverse and controversy of "watchful waiting" versus "early surgical intervention" for severe, asymptomatic, primary mitral regurgitation are addressed.

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Conflict of interest statement

The authors have no competing interests to declare. Authors contributions EA: contributed to the design of the review, drafted the original manuscript and gave final approval. ADM: contributed to the concept, created the movies, critically revised the content of the manuscript and gave final approval. AP: contributed to concept and design of the review, critically revised the content of the manuscript and gave final approval. The authors read and approved the final manuscript.

Figures

Figure 1.
Figure 1.. Mitral valve anatomy and Carpentier Classification of mitral regurgitation (from ref # [32]).
Figure 2.
Figure 2.. The TEE images demonstrates fibroelastic deficiency with prolapse and flail of P2 Scallop with torn chordae (white arrows) in 2D imaging in three different mid-esophageal TEE views (panel A, B, C) and in 3D imaging (blue arrow = P2 scallop prolapse) (black arrows = torn chordae).
Movie 1.
Movie 1.. The TEE demonstrates fibroelastic deficiency with prolapse and flail of the P2 scallop shown in 2D imaging (upper left), with color Doppler of the eccentric mitral regurgitation (upper right) and 3D TEE imaging en face from left atrium (lower right) and tilted laterally (lower left).
(“Movie files are available at https://globalcardiologyscienceandpractice.com ”)
Movie 2.
Movie 2.. The TEE demonstrates bi-leaflet mitral valve prolapse (Barlow’s disease) shown in 2D imaging in three different mid-esophageal views (upper right, upper left, lower right panels) and 3D en face view from the left atrium (lower left panel).
(“Movie files are available at https://globalcardiologyscienceandpractice.com ”)
Figure 3.
Figure 3.. (A) (left panel): Assessment of mitral regurgitation using the vena contracta width (from ref [32]).
(B) (right panel): Quantitative assessment of mitral regurgitation using the Proximal Isovelosity Surface Area method (PISA) (from [32]).
Figure 4.
Figure 4.. Summary of the indications for surgical intervention in mitral regurgitation as per the 2014 AHA/ACC valve guidelines (from [6]).
See this image and copyright information in PMC

References

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