<p>Mitral valve regurgitation (MR) and tricuspid valve regurgitation (TR) are frequent diseases that can substantially impact the quality of life by causing severe symptoms and are also associated with increased mortality. With respect to the mechanism of development, a differentiation is made between primary regurgitation, in which there is structural damage of the valve leaflets and secondary regurgitation where the valve leaflets are structurally intact and geometric alterations of the ventricles or atria impede closure of the valve. Despite the prognostic relevance of MR and TR, pharmacotherapy was the only treatment option for many patients ineligible for conventional surgery until the early 2000s. The development of various transcatheter treatment procedures over the past two decades has revolutionized the management of MR and TR and nowadays enables safe and effective treatment options for a&#xa0;broader patient population. The leaflet-based repair of the mitral valve has been proven to improve survival in well-selected, inoperable patients with secondary MR compared to pharmacotherapy. Additionally, in many studies transcatheter treatment for MR and TR enabled substantial improvements in the symptoms and quality of life. In view of the wide range of different options, the evaluation of the indications and selection of the most suitable interventional treatment approach can often be challenging. This article provides an overview of the interventional treatment options for the heart valves and the patient-oriented application .</p>

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Mitral- und Trikuspidalinsuffizienz – Wann katheterbasierte Therapie beibehalten?

  • Felix S. Nettersheim,
  • Stephan Baldus

摘要

Mitral valve regurgitation (MR) and tricuspid valve regurgitation (TR) are frequent diseases that can substantially impact the quality of life by causing severe symptoms and are also associated with increased mortality. With respect to the mechanism of development, a differentiation is made between primary regurgitation, in which there is structural damage of the valve leaflets and secondary regurgitation where the valve leaflets are structurally intact and geometric alterations of the ventricles or atria impede closure of the valve. Despite the prognostic relevance of MR and TR, pharmacotherapy was the only treatment option for many patients ineligible for conventional surgery until the early 2000s. The development of various transcatheter treatment procedures over the past two decades has revolutionized the management of MR and TR and nowadays enables safe and effective treatment options for a broader patient population. The leaflet-based repair of the mitral valve has been proven to improve survival in well-selected, inoperable patients with secondary MR compared to pharmacotherapy. Additionally, in many studies transcatheter treatment for MR and TR enabled substantial improvements in the symptoms and quality of life. In view of the wide range of different options, the evaluation of the indications and selection of the most suitable interventional treatment approach can often be challenging. This article provides an overview of the interventional treatment options for the heart valves and the patient-oriented application .