TREATMENT OF MITRAL INSUFFICIENCY USING MODERN SURGICAL AND INTERVENTIONAL PROCEDURES

Mitralna insuficijencija druga je najčešća valvularna greška koja zahtijeva kiruršku intervenciju. Karakterizira ju neadekvatan mitralni zalistak koji propušta krv retrogradno iz lijevog ventrikula u lijevi atrij tokom sistole. Mitralna insuficijencija dijeli se na primarnu i sekundarnu ovisno o etiologiji; primarna podrazumijeva grešku samog zaliska, dok je sekundarna uzrokovana patologijom lijeve klijetke. Također se može podijeliti na akutno nastalu i kroničnu insuficijenciju. Iako postoje određene farmakološke mjere koje se mogu poduzeti u liječenju mitralne regurgitacije, potpuno izlječenje može se postići isključivo kirurškim postupkom. Razlikujemo klasične otvorene operativne zahvate koji zahtijevaju kardio – pulmonalnu premosnicu te minimalno invazivne postupke koji se služe modernim tehnologijama kao što su uređaji MitraClip, PASCAL, Mitralign, Carillon, Cardioband, NeoChord i Tendyne. Za svakog bolesnika je potrebno donijeti odluku o metodi terapije uzimajući u obzir njihove individualne karakteristike, želje, indikacije i kontraindikacije.Mitral regurgitation is the second most common valvular defect requiring surgical intervention. It is characterized by an inadequate mitral valve that allows blood to flow retrogradely from the left ventricle to the left atrium during systole. Mitral regurgitation is divided into primary and secondary depending on the etiology; the primary involves an error of the valve itself, while the secondary is caused by left ventricular pathology. It can also be divided into acute and chronic insufficiency. Although there are certain pharmacological measures that can be taken in the treatment of mitral regurgitation, complete cure can only be achieved by surgical procedure. We distinguish between classic open surgical procedures that require a cardiopulmonary bypass and minimally invasive procedures that use modern technologies such as MitraClip, PASCAL, Mitralign, Carillon, Cardioband, NeoChord and Tendyne. For each patient, it is necessary to adequately plan the method of therapy, considering their individual characteristics, wishes, indications and contraindications