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Review
. 2021 Oct;46(5):419-428.
doi: 10.1007/s00059-021-05055-w. Epub 2021 Aug 16.

Current devices and interventions in mitral regurgitation

Benedikt Koell  1   2 , Daniel Kalbacher  1   2 , Edith Lubos  3   4   5
Affiliations
Review

Current devices and interventions in mitral regurgitation

Benedikt Koell et al. Herz. 2021 Oct.

Abstract
in English, German

Mitral regurgitation (MR) is the most common valvular disease. With a rising incidence in older age, the prevalence of relevant comorbidities inevitably increases. Considering the constantly aging population with high surgical risk, transcatheter therapy of MR is gaining increasing importance. Interventional therapy of either primary or secondary MR represents an alternative to pure drug or surgical therapy. With mitral valve transcatheter edge-to-edge repair, a well-established treatment has evolved in the past two decades. In addition, direct or indirect annuloplasty and ultimately transcatheter mitral valve implantation further expand the armamentarium. The current broad spectrum of interventional therapy options allows for patient-oriented therapy individually targeting different MR pathologies. This review discusses the current landscape of transcatheter therapies for relevant MR.

Die Mitralklappeninsuffizienz (MI) stellt die häufigste Herzklappenerkrankung dar. Mit einer steigenden Inzidenz im Alter erhöht sich zwangsweise die Prävalenz relevanter Komorbiditäten. In Anbetracht des alternden Patientenkollektivs mit hohem perioperativem Risiko erlangt die interventionelle Versorgung der MI zunehmende Bedeutung. Die interventionelle Therapie der primären sowie sekundären MI stellt somit eine Alternative zur rein medikamentösen bzw. chirurgischen Therapie dar. Während sich in den letzten 2 Dekaden v. a. das Verfahren der Edge-to-Edge-Therapie etablierte, ermöglichen auch andere Therapieoptionen wie eine direkte oder indirekte Annuloplastie sowie nicht zuletzt der interventionelle Mitralklappenersatz eine individuelle Therapieoption. Das aktuell breite Spektrum an interventionellen Verfahren ermöglicht eine patientenorientierte Therapie, die individuell auf die unterschiedlichen Pathologien der MI abzielt. Die vorliegende Übersicht erörtert die aktuellen kathetergestützten Therapien zur Behandlung der relevanten MI.

Keywords: Mitral valve insufficiency; Structural heart disease; Transcatheter mitral valve implantation; Transcatheter mitral valve repair; Transcatheter therapy.

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