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STATE-OF-THE-ART PAPER

Anatomy of the Mitral Valvular Complex and Its Implications for Transcatheter Interventions for Mitral Regurgitation

Nicolas M. Van Mieghem, MD^_*, Nicolo Piazza, MD^_*, Robert H. Anderson, MD, Apostolos Tzikas, MD^_*, Koen Nieman, MD^_*, Lotte E. De Laat, MD^_*, Jackie S. McGhie, BSc^_*, Marcel L. Geleijnse, MD, PhD^_*, Ted Feldman, MD, Patrick W. Serruys, MD, PhD^_* and Peter P. de Jaegere, MD, PhD^_*,_*

^_* Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
Cardiac Unit, Institute of Child Health, University College, London, United Kingdom
Cardiology Division, Evanston Hospital, Evanston, Illinois

Manuscript received February 12, 2010; revised manuscript received April 20, 2010, accepted April 26, 2010.

^_* Reprint requests and correspondence: Dr. Peter P. de Jaegere, Erasmus Medical Center, Department of Cardiology, Room Ba 587, PB 412, 3000 CA Rotterdam, the Netherlands (Email: p.dejaegere{at}erasmusmc.nl).

Mitral regurgitation (MR) poses a significant clinical burden in the adult population, which is expected to increase even more with the ever prolonging life expectancies in developed countries. New technology has brought MR, once exclusively the arena of cardiac surgeons, to the attention of interventional cardiologists. A variety of device-oriented transcatheter strategies have evolved in recent years. A comprehensive understanding of mitral valvular anatomy is crucial for the selection of patients, the implementation of devices, and further refinements of these transcatheter techniques if they are eventually to produce procedural and clinical success. The aim of this review is to elucidate the morphology of the mitral valvular complex, integrating key anatomical features into the developing transcatheter options for the treatment of MR.

Key Words: mitral regurgitation • cardiac anatomy • transcatheter strategies

Abbreviations and Acronyms   LA = left atrium/atrial   LV = left ventricle/ventricular   MR = mitral regurgitation   MV = mitral valve

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J. Am. Coll. Cardiol. 2010 56: A25. [Full Text] [PDF]