Pathophysiology and management of combined aortic and mitral regurgitation

[en] The combination of aortic and mitral regurgitation is a typical example of a frequent yet understudied multiple valve disease scenario. The aetiology is often rheumatic or degenerative; less frequently it can be induced by drugs or radiation, or caused by infective endocarditis or congenital valvular lesions. Aortic regurgitation resulting in secondary mitral regurgitation is also not uncommon. There are limited data to guide the management of combined aortic and mitral regurgitation. Left ventricular dysfunction is frequent at initial presentation, and even more so postoperatively, suggesting that surgical management should not be delayed, particularly when symptoms occur or when there is evidence of even subtle left ventricular dysfunction. The decision to operate on one or both valves not only depends on the severity of each lesion, but also on several other factors, including age, co-morbidities and frailty, the increased operative risk of double valve surgery, the increased risk of long-term thrombotic and bleeding complications with multiple mechanical valves, the risk of leaving one valve unoperated and the probability of requiring redo surgery. The role of a multidisciplinary heart valve team is critical in this setting to optimize management and outcomes. The role of transcatheter approaches is currently limited, but technological advances will probably soon change the management paradigm. © 2019 Elsevier Masson SAS

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Unger, P.; Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium

Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Amzulescu, M.; Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium

David-Cojocariu, A.; Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium

de Cannière, D.; Department of Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, 1000, Belgium

Language :

English

Title :

Pathophysiology and management of combined aortic and mitral regurgitation

Alternative titles :

[fr] Physiopathologie et prise en charge des insuffisances valvulaires aortiques et mitrales combinées

Publication date :

2019

Journal title :

Archives of Cardiovascular Diseases

ISSN :

1875-2136

eISSN :

1875-2128

Publisher :

Elsevier Masson SAS

Issue :

112

Pages :

430-440

Peer reviewed :

Peer reviewed

Available on ORBi :

since 19 November 2019

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293 (1 by ULiège)

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