About this Research Topic
Over the last decade the development of percutaneous devices and techniques for the treatment of structural heart diseases has changed our daily cardiology practice. Transcatheter aortic valve replacement is now widely used in patients at high and moderate risk for conventional surgical aortic valve replacement and is being evaluated in randomized trials for the treatment of patients at low surgical risk. TAVR is also being evaluated for patients with moderate aortic stenosis combined with left ventricular dysfunction and also in asymptomatic patients. This treatment was also the keystone for the foundation of the contemporary concept of the “heart team”, now deeply embraced by the cardiology community. The “heart team” allows us to provide a more comprehensive and multidisciplinary assessment and treatment to our patients with structural heart problems.
Transcatheter mitral valve replacement with the MitraClip device has shown favorable outcomes in patients with symptomatic severe and primary mitral regurgitation at prohibitive surgical risk. This device is being evaluated for patients with functional mitral regurgitation. Following these novel approaches for the treatment of aortic stenosis and mitral regurgitation new challenges and standards were set for the rapidly evolving field of percutaneous treatments of structural heart diseases.
General cardiologists, interventional cardiologists, cardiac surgeons, imaging specialists, valve and heart failure specialists, and cardiac anesthesiologists face a new era in which medicine fuses with innovation and device engineering and provides new insights and therapeutic solutions for patients. A wide pool of medical devices for the treatment of patients with mitral valve diseases are at different stages of development. These devices are being extensively tested and evaluated and will certainly provide alternatives for the better care of patients with these diseases. In parallel more research is needed to shed light on the indications, timing and type of interventions needed in patients with mitral disease, in particular for those suffering from functional mitral regurgitation.
In the following series of articles, we will explore the challenges faced by each of the different cardiology subspecialties involved in the care of patients with mitral valve disease. The authors are encouraged to discuss the diagnosis, classification, indication and timing for intervention, types of treatments, medical devices and clinical care and follow up of this patient population in order to establish a platform for academic discussion that will enhance our understanding of these diseases and contribute for a better care of our patients.
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