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Combined aortic and mitral regurgitation: A scenario difficult to manage
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
2012 (English)In: Journal of Cardiovascular Echography, ISSN 2211-4122, Vol. 22, no 4, 140-145 p.Article, review/survey (Refereed) Published
Abstract [en]

Objectives: The simultaneous presence of substantial regurgitation of both the aortic and the mitral valve imposes a massive volume load and, due to the aortic regurgitation, a pressure load on the left ventricle. This condition usually is caused by primary aortic regurgitation and concomitant functional mitral regurgitation due to left ventricular enlargement, but lesions can also be primary in both valves, as in endocarditis, carcinoid disease, or due to the cardiotoxicity of appetite-depressant drugs. Because dilatation of the left ventricle caused by chronic aortic regurgitation mostly is not fully reversible by aortic valve surgery, it is unlikely that severe or moderate mitral regurgitation will regress significantly after aortic valve surgery alone. In such cases, simultaneous repair of a severely regurgitant mitral valve is recommended by the guidelines, but the recommendation should probably be extended to moderate mitral regurgitation too. Conclusion: In treating combined aortic and mitral regurgitation, the incomplete reversibility of left ventricular dilatation due to aortic regurgitation should be kept in mind. If indications for aortic valve replacement are fulfilled, concomitant mitral valve repair should be strongly considered.

Place, publisher, year, edition, pages
2012. Vol. 22, no 4, 140-145 p.
Keyword [en]
Aortic regurgitation, Cardiac surgery, Left ventricular remodelling, Mitral regurgitation, Mitral valve repair
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-193874DOI: 10.1016/j.jcecho.2012.09.002OAI: oai:DiVA.org:uu-193874DiVA: diva2:603661
Available from: 2013-02-06 Created: 2013-02-06 Last updated: 2013-02-06Bibliographically approved

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Flachskampf, Frank A.

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