Mitral Regurgitation (MR) accounts for the vast majority of all mitral valve diseases.1 It has a prevalence of approximately 2% in the general population and is more common in the elderly population.3 Approximately 10% of people over the age of 70 have clinically meaningful MR.5
If left untreated, MR can lead to Heart Failure (HF), or deterioration of pre-existing HF, resulting in an increased number of hospital admissions and a substantial cost burden to health systems.6,8
Mitral Regurgitation (MR) occurs when the mitral valve leaflets fail to properly close during ventricular contraction (systole) so blood flows back into the left atrium, leading to inefficient pumping of blood around the body.9,18
Primary (e.g. degenerative or organic) Mitral Regurgitation (PMR) is caused by abnormalities in one or more components of the mitral valve architecture, such as the leaflets, chordae, or papillary muscles.10,11
Secondary Mitral Regurgitation (SMR), also referred to as Functional Mitral Regurgitation (FMR), occurs as a result of left ventricle dysfunction, which is typically caused by ischaemic heart disease or dilated cardiomyopathy. In SMR, the mitral valve is in itself normal.10,11
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Treatment of MR is guided by the disease classification (primary/secondary) and severity. In SMR the approach to treatment is also guided by the nature of the patient’s underlying heart disease. The best treatment approach for a given patient and their condition (whether it be PMR or SMR) is determined by a Multidisciplinary Heart Team (MDT).16 Treatment options for MR include medical management, surgical repair or replacement, and Transcatheter Mitral Valve repair (TMVr) or Replacement (TMVR). Transcatheter Edge-to-Edge Repair (TEER) is a minimally invasive TMVr option.
HF 2022: FMR
EACTS 2022: Tendyne™ vs on-pump MVR
EACTS 2022: SMV repair vs replacement
ESC 2022: TEER Tutorial
ESC 2022: FMR
PCRLV 2021: Transcatheter mitral valve replacement
EACTS 2021: Transcatheter mitral valve implantation
EACTS 2021: A valve-for-life
EACTS 2021: Impact of MVR Guidelines
EACTS 2021: MVR Guidelines update
ACC 2023: COAPT™ trial
Tendyne™: 6-Year Outcomes
PCRLV 2021: Transcatheter mitral valve replacement
EuroEcho 2021: MR Treatment (Patient)
ESC 2022: FMR
EuroEcho 2021: MR Treatment (Evidence)
TCT 21: EXPAND G4
ESC 2021: HF & VHD Guidelines
EXPAND Study: Data overview
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Working Groups on Cardiovascular Surgery and Valvular Heart Disease. Eur Heart J. 2016;37(2):133–9. doi.org/10.1093/eurheartj/ehv322.
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www.cqc.org.uk/_db/_documents/Pushing_the_boundaries_Improving_services_for_patients_with_heart_failure_200707020413.pdf (last accessed: 23 March 2023).
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diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA)
of the ESC. Eur Heart J. 2021;42(36):3599–3726. doi.org/10.1093/eurheartj/ehab368.
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valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Euro Heart J. 2022;43(7):561–632.
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A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143(5):e35–e71.
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