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[Surgery or medical therapy for secondary mitral regurgitation?]. / Sekundär-funktionelle Mitralinsuffizienz bei Herzinsuffizienz: Tabletten oder Messer?
Schaefer, Arnd.
Afiliación
  • Schaefer A; Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Germany. schaefer.arnd@mh-hannover.de
Herz ; 34(2): 118-23, 2009 Mar.
Article en De | MEDLINE | ID: mdl-19370327
Mitral regurgitation (MR) is the second most frequent valve disease in Europe. In addressing the current therapy for MR, it is useful to distinguish primary from secondary or functional MR. In primary MR, there is derangement of the mitral valve itself causing left ventricular volume overload and left ventricular dysfunction. By contrast, in secondary MR, the valve and its components are typically normal and MR is related to changes of annular size (dilatation) and papillary muscle displacement due to left ventricular damage caused by myocardial infarction or dilated cardiomyopathy.In primary MR, mitral valve repair or replacement is the first-line therapy. In secondary MR, the best management includes standard medical therapy for heart failure and cardiac resynchronization therapy in selected patients. Since there is no evidence from randomized studies that surgery improves mortality, this approach may only be considered in patients who remain symptomatic despite optimal medical therapy or in patients undergoing coronary revascularization.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Cardiovasculares / Estimulación Cardíaca Artificial / Cardiotónicos / Insuficiencia de la Válvula Mitral Tipo de estudio: Clinical_trials Límite: Humans Idioma: De Revista: Herz Año: 2009 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Cardiovasculares / Estimulación Cardíaca Artificial / Cardiotónicos / Insuficiencia de la Válvula Mitral Tipo de estudio: Clinical_trials Límite: Humans Idioma: De Revista: Herz Año: 2009 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania