Percutaneous mitral valve repair for Coronary Artery Disease

We have found evidence that the presence of the signs of premature cardiovascular disease (signs of CHD, heart attack, or stroke) increases a patient's risk for developing advanced stages of coronary artery disease. Further work with larger study groups is needed to clarify this relationship more completely.

There appear to be benefits of regular exercise and avoidance of smoking, eating a healthy diet, and controlling hypertension. A healthy, lifestyle is an effective treatment for chronic coronary artery disease.

Appropriate use of revascularization is widely practiced but high quality evidence is lacking. Aspirin and beta-blockers are not recommended for prevention of recurrent coronary events for patients with stable CAD.

The American Heart Association estimates that there will be around 806,000 new diagnoses of CAD between 2003 and 2030 in the US. This represents an absolute increase of 27% in diagnoses between 2003 and 2030. The projected increase over time, at 5 years, of 7.6% will be very similar to the absolute number of people with coronary disease. The difference in absolute numbers is due, at least in part, to the different inclusion criteria and diagnostic tools used in the two analyses.

Approximately 2.8 million people in Canada have at least one stenosis severity rating of one or more coronary arteries. The rates are highest among the male and elderly population. More than 75% also have CAD, and half have evidence of previous disease. The occurrence and severity of CAD are predicted by age, sex, risk factors, co-morbidities, and ethnicity. CAD is the third most common cause of acute coronary syndrome in Canada, accounting for one in three cases. It also plays a significant role in predicting future death from CAD. The most common manifestation of CAD is unstable angina, followed by non-ST-segment elevation myocardial infarction.

There is accumulating evidence that both genetics and the environment play a significant role in the development of CAD. There is also strong evidence that a combination of these factors are involved in the pathogenesis of the disease.

Yes, there have been new discoveries but they are limited to new methods of treatment of angina, including cardiac resynchronisation therapy (CRT). CRT may help reduce death for patients with severe coronary artery disease. CRT combines the idea that the heart muscle beats more forcefully due to abnormal electrical conduction between the heart chambers, which is known as heart failure, with the concept that the heart muscle can contract more forcefully more easily than heart muscle if abnormal electrochemical signalling can be corrected, therefore aiding heart muscle contraction. For example, if the abnormal heart muscle activity is caused by abnormal electrical contraction (e.g.

Most individuals with coronary artery disease remain asymptomatic. Only a minority will be hospitalized with myocardial infarction per year despite being in high risk categories due to smoking, hypertension, and low levels of exercise.

This retrospective review found that a high percentage of patients with [dilated mitral regurgitation were treated with percutaneous mitral valve repair. Patients with rheumatic mitral regurgitation received repair at a slightly lower rate, but there was no difference in their clinical outcomes.] There was a significant rate of postprocedural and long-term improvement and an acceptable number of complications. It seems that patients with rheumatic mitral regurgitation and [dilated mitral regurgitation who were treated with percutaneous valve repair had comparable outcomes. Patients with rheumatic MR and [dilated mitral regurgitation who were treated with [percutaneous valves repair had significantly better clinical outcomes.

In recent years, coronary artery disease has become the most common reason for coronary bypass graft procedures. Today, there are multiple surgical and percutaneous approaches to treat coronary artery disease. Most recent evidence suggest that drug-eluting stents (DES) are an effective means to prevent recurrence after coronary artery disease treatment.

In the treatment of rheumatic valve disease, PMVR is the definitive procedure, providing excellent short-term and long-term results in the appropriately selected patient population. The indications for PMVR should be expanded by more stringent application of accepted indications and clinical practice guidelines.