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Mitral Regurgitation Therapy Needs Clarification

Important to establish primary or secondary mitral regurgitation when addressing appropriate therapy

THURSDAY, July 24 (HealthDay News) -- Mitral valve repair is the preferred therapy for primary mitral regurgitation, but indications for surgery in secondary mitral regurgitation are less certain, according to a report in the July 29 issue of the Journal of the American College of Cardiology.

Blase A. Carabello, M.D., of the Baylor College of Medicine in Houston, reviews the "state-of-the-art" related to mitral regurgitation. The report reviews the pathophysiology, indications for testing, and treatment for both primary and secondary mitral regurgitation.

While deformities of the mitral valve lead to leakage and left ventricular volume overload in primary mitral regurgitation, this physiologic state leads to ventricular remodeling, myocardial dysfunction, heart failure, and death if not treated, the author writes. Mitral valve repair should occur when patients become mildly symptomatic, or when ejection fraction nears 0.60 or end systolic dimension approaches 40 mm. In secondary mitral regurgitation, the valve itself is not the primary problem and indications for intervention on the valve are less certain, but aggressive treatment of the underlying condition causing mitral regurgitation may be more beneficial, Carabello reports.

"Percutaneous therapies for both primary and secondary mitral regurgitation have generated much interest, and many different percutaneous technologies are being developed. Future data from randomized trials will help clarify when and in whom these therapies are applicable," the author concludes.

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