A PCR statement on behalf of PCR and the EAPCI
Paris, France, 21 May 2019. Heart failure is a common cardiovascular disorder with ominous prognosis despite significant therapeutic advances. Mitral regurgitation (MR, leaking of the mitral valve within the heart) affects at least 50% of patients with heart failure and is independently associated with worse prognosis. Timely diagnosis is essential, and management is complex, requiring an expert approach. These patients should be referred for assessment and management by a multidisciplinary Heart Team.
Detailed imaging assessment is essential to confirm the diagnosis and severity of MR and provide further insights into cardiac anatomy and function that will guide the choice of management.
The first essential step in management is the institution of optimised pharmacological therapy and use of cardiac resynchronisation devices according to guideline recommendations. Recent evidence supports the use of transcatheter mitral edge-to-edge repair using the MitraClip device in carefully selected patients with heart failure-associated MR who remain symptomatic despite these measures.
Surgical treatment of heart failure-associated MR should be considered in patients with coronary artery disease undergoing surgical revascularisation. Circulatory support devices and cardiac transplantation are an alternative in patients with extreme left and/or right ventricular failure and no accompanying severe comorbidity.
Expensive, high-risk and ultimately futile procedures should be avoided in patients who will derive little or no symptomatic benefit or quality of life improvement. Specialist palliative care should be available for these patients.
This summary is based upon a published Viewpoint article [1] and underpins a more extensive joint position statement in preparation by a collaborative working group derived from the European Association of Percutaneous Cardiovascular Intervention (EAPCI), European Heart Rhythm Association (EHRA), European Association of Cardiovascular Imaging (EACVI) and Heart Failure Association (HFA) of the European Society of Cardiology.
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REFERENCE
[1] Praz F, Grasso C, Taramasso M, Baumbach A, Piazza N, Tamburino C, Windecker S, Maisano F, Prendergast B. Mitral regurgitation in heart failure – time for a rethink. Eur Heart J 2019 April 21. doi:10.1093/eurheartj/ehz222.
NOTES TO EDITORS
Key information
- Percutaneous edge-to-edge repair in patients with heart failure and secondary mitral regurgitation: a PCR statement presented by Bernard Prendergast
- Palais des Congrès Porte Maillot – Paris, France
- Tuesday 21 May 2019 – 12:15 – Main Arena
EuroPCR 2019
The World-Leading Course in interventional cardiovascular medicine and the official annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) will take place from 21 to 24 May 2019 at the Palais des Congrès – Paris, France. The detailed Course Programme is available on: https:/
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The mission of PCR is to serve the needs of each individual patient by helping the cardiovascular community to share knowledge, experience and practice. PCR offers a large range of many other educational meetings and resources for the continuing education of the interventional cardiovascular community. These include major annual Courses across the globe, e-Learning with high-profile PCR Webinars, Courses specifically dedicated to valvular heart disease, tailor-made PCR Seminars on specific topics, online resources and medical publications such as EuroIntervention, the official journal of the EAPCI.
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