Management of Severe Mitral Regurgitation in Patients With Acute Myocardial Infarction: JACC Focus Seminar 2/5 (JACC May 2024-1)-Article: Management of Severe Mitral Regurgitation in Patients With Acute Myocardial Infarction: JACC Focus Seminar 2/5

Article: Management of Severe Mitral Regurgitation in Patients With Acute Myocardial Infarction: JACC Focus Seminar 2/5

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The document explores the management of severe mitral regurgitation following acute myocardial infarction (MI) and compares traditional surgical interventions with emerging transcatheter approaches. Mitral regurgitation post-MI can have severe consequences but can be addressed through methods like surgical repair and transcatheter interventions such as transcatheter edge-to-edge repair (TEER) with devices like MitraClip. While surgery is typically preferred, TEER has shown promising outcomes in reducing mitral regurgitation and improving survival rates, especially in high-risk patients. The document stresses the importance of timely intervention, imaging modalities like echocardiography for diagnosis, and the role of a dedicated heart team in treatment decisions. It also discusses the challenges faced in managing acute mitral regurgitation post-MI and suggests a multidisciplinary approach involving specialists from various fields. The potential benefits of TEER, such as immediate hemodynamic improvement and lower bleeding risks compared to surgery, are highlighted, calling for further research to optimize management strategies for this condition.

Keywords

severe mitral regurgitation

acute myocardial infarction

surgical interventions

transcatheter approaches

transcatheter edge-to-edge repair

MitraClip

echocardiography

heart team

multidisciplinary approach

immediate hemodynamic improvement