INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

MITRAL VALVE INTERVENTIONAL PROCEDURES: LONG-TERM OUTCOMES AND FOLLOW-UP

Mehmet Hakan Uzun

Kütahya City Hospital, Department of Cardiology, Kütahya, Türkiye

Uzun MH. Mitral Valve Interventional Procedures: Long-Term Outcomes and Follow-Up. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.165-175.

ABSTRACT

The first application of transcatheter mitral valve procedures with successful long-term outcomes was performed in 1984 with percutaneous mitral balloon commissurotomy (PMBC), which is now routinely applied in clinical practice. Additionally, advancements in imaging and material technologies have made many new treatment modalities an integral part of modern interventional therapeutic approaches.

Mitral valve pathologies are mainly classified as mitral stenosis (MS) and mitral regurgitation (MR). Mitral regurgitation is further divided into two primary categories: primary MR, caused by structural abnormalities, and secondary MR, resulting from functional anomalies due to left ventricular and/ or left atrial pathologies. The selection of transcatheter treatment modalities varies depending on the classification of the underlying mitral valve disease. Furthermore, the long-term follow-up outcomes of interventional treatments for different mitral valve diseases also vary significantly based on the underlying pathology.

Transcatheter approach to mitral stenosis consists of PMBC and transcatheter mitral valve replacement (TMVR). In the interventional treatment of mitral regurgitation, there are two options: mitral valve repair and TMVR. In mitral valve repair; transcatheter edge-to-edge repair (TEER), transcatheter annuloplasty, and transcatheter chordal repair are currently applicable treatment modalities. In addition to the technical characteristics of the method used, long-term outcomes vary depending on the features of the valve pathology, and long-term follow-up studies for new treatment modalities are still ongoing.

Keywords: Heart valve; Heart valve prosthesis implantation; Mitral valve; Mitral valve stenosis; Mitral valve insufficiency

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