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The five Ws of transcatheter mitral valve repair: Who, What, When, Where, and Why

EuroIntervention 2019;15:837-840. DOI: 10.4244/EIJV15I10A158

1. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2. The Cardiovascular Research Foundation, New York, NY, USA; 3. Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy

Mitral regurgitation (MR) has numerous aetiologies, but may broadly be classified as either primary MR (PMR; also termed degenerative or organic MR) or secondary MR (SMR; also termed functional MR)1. PMR arises from structural changes in the valve itself or supporting structures, whereas the principal derangement in SMR is global or regional left ventricular dysfunction due to ischaemic or non-ischaemic cardiomyopathy resulting in apical and lateral distraction of the papillary muscles and subsequent tethering of the mitral leaflets with lack of coaptation. In SMR, the mitral valve complex is structurally normal until late in its course when annular dilatation ...

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