PURPOSE OF REVIEW: To analyze the current state of the art of functional mitral regurgitation (FMR) treatment. RECENT FINDINGS: The first-line treatment of severe FMR consists of guideline medical therapy (GMT) and resynchronization therapy when indicated; the impact of new medical therapies like sacubitril/valsartan needs further assessment. Valvular intervention may be considered in FMR symptomatic patients despite GMT, and can be performed surgically or percutaneously. MitraClip is a safe percutaneous procedure associated with symptoms improvement. Recently, the COAPT trial showed superior outcomes for MitraClip versus GMT contrasting the MITRA-FR trial which showed no benefit of MitraClip compared with GMT. These results should be interpreted as complementary rather than opposite. The COAPT trial provided a "proof of concept" that percutaneous treatment of severe FMR in patients without too advanced left ventricular disease translates into a prognostic benefit. Careful patient selection will play a critical role in defining the clinical niche for successful interventions.
PURPOSE OF REVIEW: To analyze the current state of the art of functional mitral regurgitation (FMR) treatment. RECENT FINDINGS: The first-line treatment of severe FMR consists of guideline medical therapy (GMT) and resynchronization therapy when indicated; the impact of new medical therapies like sacubitril/valsartan needs further assessment. Valvular intervention may be considered in FMR symptomatic patients despite GMT, and can be performed surgically or percutaneously. MitraClip is a safe percutaneous procedure associated with symptoms improvement. Recently, the COAPT trial showed superior outcomes for MitraClip versus GMT contrasting the MITRA-FR trial which showed no benefit of MitraClip compared with GMT. These results should be interpreted as complementary rather than opposite. The COAPT trial provided a "proof of concept" that percutaneous treatment of severe FMR in patients without too advanced left ventricular disease translates into a prognostic benefit. Careful patient selection will play a critical role in defining the clinical niche for successful interventions.
Authors: Paul A Grayburn; Elyse Foster; Chithra Sangli; Neil J Weissman; Joseph Massaro; Donald G Glower; Ted Feldman; Laura Mauri Journal: Circulation Date: 2013-09-06 Impact factor: 29.690
Authors: Anna Sannino; Robert L Smith; Gabriele G Schiattarella; Bruno Trimarco; Giovanni Esposito; Paul A Grayburn Journal: JAMA Cardiol Date: 2017-10-01 Impact factor: 14.676
Authors: Georg Nickenig; Rodrigo Estevez-Loureiro; Olaf Franzen; Corrado Tamburino; Marc Vanderheyden; Thomas F Lüscher; Neil Moat; Susanna Price; Gianni Dall'Ara; Reidar Winter; Roberto Corti; Carmelo Grasso; Thomas M Snow; Raban Jeger; Stefan Blankenberg; Magnus Settergren; Klaus Tiroch; Jan Balzer; Anna Sonia Petronio; Heinz-Joachim Büttner; Federica Ettori; Horst Sievert; Maria Giovanna Fiorino; Marc Claeys; Gian Paolo Ussia; Helmut Baumgartner; Salvatore Scandura; Farqad Alamgir; Freidoon Keshavarzi; Antonio Colombo; Francesco Maisano; Henning Ebelt; Patrizia Aruta; Edith Lubos; Björn Plicht; Robert Schueler; Michele Pighi; Carlo Di Mario Journal: J Am Coll Cardiol Date: 2014-09-02 Impact factor: 24.094
Authors: Sven T Pleger; Marius Schulz-Schönhagen; Nicolas Geis; Derliz Mereles; Emmanuel Chorianopoulos; Muliadi Antaredja; Markus Lewening; Hugo A Katus; Raffi Bekeredjian Journal: Eur J Heart Fail Date: 2013-03-19 Impact factor: 15.534
Authors: Tomislav Mihaljevic; Buu-Khanh Lam; Jeevanantham Rajeswaran; Masami Takagaki; Michael S Lauer; A Marc Gillinov; Eugene H Blackstone; Bruce W Lytle Journal: J Am Coll Cardiol Date: 2007-05-18 Impact factor: 24.094