“Surgical Treatment of Degenerative Mitral Valve Disease-Causing Mitral Regurgitation: State Of The Art”

Abstract

Degenerative Mitral Valve Disease (DMVD) is common in developed countries that frequently causes mitral regurgitation (MR). The natural history of DMVD is not well demonstrated. Therefore, timely and suitable interventions are the determinant of post-intervention clinical outcomes, life quality, and life expectancy of patients. The severity of MR can be precisely assessed by doppler-echocardiographic imaging. However, no medical management has been proven to be effective in averting the volume overload related sequel of asymptomatic degenerative MR. Therefore, mitral valve surgery (MVS) is the gold standard treatment strategy for DMVD. Notwithstanding, MVS is the only sorts of treatment strategy which provides long term natural and complication-free clinical outcome to otherwise healthy DMVD patients. However, mitral valve (MV) repair provides better clinical outcomes compared to MV replacement, along with the significant reduction of postoperative mortality rate about 70%. Currently, MVS is carried out using minimally invasive techniques or robotic-assisted techniques. Nonetheless, MVS using percutaneous techniques is evolving in the treatment for DMVD patients. This state-of-the-art-review is aimed to delineate the recent knowledge of DMVD, which includes the natural history of the disease, diagnostic modalities, recent treatment strategies, and clinical follow-up results.