COMPARISON BETWEEN REPAIR OF MITRAL VALVE REGURGITATION USING SURGICAL METHOD AND USING PERCUTANEOUS CATHETERIZATION

Abstract

Mitral valve regurgitation (MR), defined as retrograde flow from the left ventricle (LV) into the left atrium during systole. Mitral valve disease was diagnosed by direct surgical inspection, pathologic reports, and echocardiograms. The natural history of severe MR is un¬favorable, leading to worsening LV failure, pulmonary hypertension, atrial fibrilla¬tion, and death. MR can be broadly classified into two major categories, the first is degenerative MR where there may be annular dilatation, leaflet thickening, myxoid degeneration, chordal elongation and rupture, and both annular and leaflet calcification. It may affect both leaflets, but mainly the posterior one. The second is functional MR which is either due to ischemic or dilated cardiomyopathy. Optimal medical treatment is obviously required as standard therapy for symptomatic patients. When symptoms persist despite maximal medical therapy, or severe MR exists or LV dysfunction is present, valvular surgery should be considered before LV function becomes further depressed. What this surgery should be—whether replacement, repair or percutaneous MitraClip —remains a very controversial topic. Surgical repair represents the opti¬mal treatment for severe DMR because of its well-documented advantages over valve replacement in terms of perioper¬ative mortality, preservation of postoper¬ative LV function, and long-term surviv¬al. Indeed, if performed before the onset of limiting symptoms or the devel¬opment of LV dysfunction, MV repair is able to restore normal life expectancy and quality of life.