Guidance for Transcatheter Mitral Regurgitation Treatment Issued

Early Mitral Surgery Best for Mitral Valve Regurgitation
Early Mitral Surgery Best for Mitral Valve Regurgitation
Professional societies should set minimal performance standards.

(HealthDay News) – Guidance has been issued relating to transcatheter therapies for mitral regurgitation; the document has been published online Nov. 25 in the Journal of the American College of Cardiology.

The document was drafted by the American College of Cardiology, the American Association for Thoracic Surgery, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons. The authors, Patrick T. O’Gara, MD, from Brigham and Women’s Hospital in Boston, and colleagues, discuss issues related to transcatheter therapies for mitral regurgitation, including care protocols.

The authors note that transcatheter therapy for mitral regurgitation should be carried out at high volume centers of excellence, with a multidisciplinary heart team that should include general cardiologists, heart valve experts, advanced imagers, interventionalists, cardiac surgeons, and others. After the procedure, patients should be cared for in specialized cardiac or cardiac surgical intensive care units. Professional societies should establish minimal performance standards, and should develop the curriculum, establish metrics for assessment, and certify completion of a training module. Protocols should include assessment of the structure and function of the mitral valve, cardiac chamber sizes, biventricular function, pulmonary artery pressures, and any additional cardiac pathology, as well as a full assessment of medical comorbidities. Specific protocols are needed for patient assessment and care before, during, and after procedures, with clear delineation of the roles of individual heart team members and establishment of a collaborative process for shared decision making.

“The authors and societies envision this document serving as a broad guideline for the responsible deployment of these new therapies for our patients and teams,” John H. Calhoon, MD, co-chair of the writing committee, said in a statement.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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