Mitral and tricuspid valve disease: diagnosis and management. Consensus document of the Section on Valvular Heart Disease and the Cardiovascular Imaging, Clinical Cardiology, and Interventional Cardiology Associations of the Spanish Society of Cardiology

Mitral transcatheter edge-to-edge repair: patient selection, current devices, and clinical outcomes

INTRODUCTION

Over the last two decades, mitral transcatheter edge-to-edge repair (M-TEER) has become a safe and effective therapy for severe mitral regurgitation in patients deemed at high surgical risk.

AREAS COVERED

This review aims to encompass the most relevant and updated evidence in the field of M-TEER from its inception, focusing on clinical and anatomical features for proper patient and device selection.

EXPERT OPINION

Growing operator experience and device iterations have resulted in improved clinical outcomes and an expansion of the therapy to patients with complex anatomies and clinical scenarios. Future investigations are warranted to determine the best management options and the most suitable device for every patient with MR.

Surgical Reconstruction of Mitral Restenosis Complicated by a Critically Small Left Ventricular Cavity and Giant Left and Right Atriomegaly (Clinical Case)

Background. Comprehensive reconstruction of the left and right parts of the heart in giant left atriomegaly, adequate tactics of mitral valve replacement in case of concomitant tricuspid insufficiency and dilation of the right atrium lead to an improvement in the functional state of the myocardium as early as at the hospital stage. Case description. Patient B., a 67-year-old woman, was examined and treated from July 12 to August 2, 2016 at the Department of Surgical Treatment of Acquired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: stage IV mitral restenosis, condition after closed mitral commissurotomy in 2001, critically small cavity of the left ventricle, giant left atriomegaly, IV degree tricuspid insufficiency, right atriomegaly, high pulmonary hypertension, permanent form of atrial fibrillation for 15 years since 2001, NYHA class IV heart failure, IIB. The patient underwent surgical intervention: mitral valve replacement + W-shaped plastic surgery of the left atrium in combination with dosed resection of left atrium + tricuspid valve plasty with the imposition of a support ring + resection of the right atrium. Conclusion. Given the initial serious condition of the patient with advanced mitral restenosis, critically small left ventricular cavity, giant left atriomegaly of 169.4 × 115.8 mm (according to computed tomography) and high pulmonary hypertension (65 mm Hg), concomitant pathology of the right parts of the heart (tricuspid insufficiency and right atriomegaly), adequate tactics in mitral valve replacement and radical correction of the left atriomegaly lead to an improvement in the functional state of the heart as early as at the hospital stage.