The treatment of mitral and aortic valve disease underwent major refinements over the last decade, with the focus being increasingly shifted towards patient-centered and individualized treatment protocols. Surgical techniques were further standardized and increasingly targeted towards valve-sparing techniques; particularly in young patients presenting with a mitral or aortic valve regurgitation. Native valve preserving techniques bear substantial advantages regarding long-term outcomes by providing the best possible durability and hemodynamic superiority in comparison to prosthetic valve replacement. Furthermore, some progress was achieved in the surgical treatment of secondary mitral regurgitation by adding subvalvular repair techniques to an isolated annuloplasty. All these developments made a meaningful contribution to individualized treatment of mitral and aortic valve disease.
In this Research Topic we aim to elucidate individualized surgical decision making aspects in the treatment of mitral and aortic valve disease. The strategy of valve-sparing vs. prosthetic valve replacement, especially in younger patients, merits an extensive discussion on the pros and cons, and raises the important issue of specialized Valve Repair Centers. Furthermore, ongoing surgical-technical refinements in native valve-sparing therapies, including minimally-invasive approaches warrant a thorough and in-depth interdisciplinary discussion. Current achievements in Ross surgery are similarly fascinating and provide an excellent therapeutic option in appropriately selected patients. On the mitral side, there were some important developments in the individualized treatment of functional mitral regurgitation (FMR) depending on the pathophysiological mechanism of regurgitation (i.e., atrial vs. ventricular FMR) as well as in the treatment of complex degenerative mitral valve disease (e.g., Mb. Barlow). Most importantly, current decision-making process increasingly integrates an interdisciplinary heart-team as a key-element in the current personalized medicine.
Key aspects of research to be considered in this special issue include:
1) Native valve-sparing surgical strategies and minimally-invasive approaches in the treatment of mitral and aortic valve disease.
2) Current indications for native valve preservation in mitral and aortic valve disease (e.g., aortic valve repair, Ross surgery, mitral valve repair in secondary mitral regurgitation).
3) Modern perioperative treatment protocols (e.g., ERAS model) in patients with valvular heart disease.
4) The value of Ross surgery in the treatment of young adults with aortic valve disease with a special interest in the importance of individualized decision-making by an institutional heart-team.
5) Pathophysiology-based approach to functional mitral regurgitation: atrial vs. ventricular FMR.
6) New evidence in the treatment of complex degenerative mitral valve disease.
The treatment of mitral and aortic valve disease underwent major refinements over the last decade, with the focus being increasingly shifted towards patient-centered and individualized treatment protocols. Surgical techniques were further standardized and increasingly targeted towards valve-sparing techniques; particularly in young patients presenting with a mitral or aortic valve regurgitation. Native valve preserving techniques bear substantial advantages regarding long-term outcomes by providing the best possible durability and hemodynamic superiority in comparison to prosthetic valve replacement. Furthermore, some progress was achieved in the surgical treatment of secondary mitral regurgitation by adding subvalvular repair techniques to an isolated annuloplasty. All these developments made a meaningful contribution to individualized treatment of mitral and aortic valve disease.
In this Research Topic we aim to elucidate individualized surgical decision making aspects in the treatment of mitral and aortic valve disease. The strategy of valve-sparing vs. prosthetic valve replacement, especially in younger patients, merits an extensive discussion on the pros and cons, and raises the important issue of specialized Valve Repair Centers. Furthermore, ongoing surgical-technical refinements in native valve-sparing therapies, including minimally-invasive approaches warrant a thorough and in-depth interdisciplinary discussion. Current achievements in Ross surgery are similarly fascinating and provide an excellent therapeutic option in appropriately selected patients. On the mitral side, there were some important developments in the individualized treatment of functional mitral regurgitation (FMR) depending on the pathophysiological mechanism of regurgitation (i.e., atrial vs. ventricular FMR) as well as in the treatment of complex degenerative mitral valve disease (e.g., Mb. Barlow). Most importantly, current decision-making process increasingly integrates an interdisciplinary heart-team as a key-element in the current personalized medicine.
Key aspects of research to be considered in this special issue include:
1) Native valve-sparing surgical strategies and minimally-invasive approaches in the treatment of mitral and aortic valve disease.
2) Current indications for native valve preservation in mitral and aortic valve disease (e.g., aortic valve repair, Ross surgery, mitral valve repair in secondary mitral regurgitation).
3) Modern perioperative treatment protocols (e.g., ERAS model) in patients with valvular heart disease.
4) The value of Ross surgery in the treatment of young adults with aortic valve disease with a special interest in the importance of individualized decision-making by an institutional heart-team.
5) Pathophysiology-based approach to functional mitral regurgitation: atrial vs. ventricular FMR.
6) New evidence in the treatment of complex degenerative mitral valve disease.
