علاج قصور الصمام التاجي الحاد مع انخفاض كسر الطرد البطيني الأيسر في قصور الصمام التاجي البطيني الثانوي الشديد

References

DOI: 10.1093/eurheartj/ehaf194

• In patients with ventricular SMR, GDMT for the treatment of HF is recommended prior to any MV intervention.
• The combination of ACE-Is/ARBs or angiotensin receptor/neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium–glucose co-transporter 2 inhibitors (SGLT2is) at the maximum tolerated doses is recommended according to the HF Guidelines.
• Cardiac resynchronization therapy (CRT) should also be considered as part of HF management before an MV intervention according to HF guideline criteria (LVEF ≤35% and wide QRS).
• TEER is recommended to reduce HF hospitalizations and improve quality of life in haemodynamically stable, symptomatic patients with impaired LVEF (<50%) and persistent severe ventricular SMR, despite optimized GDMT and CRT (if indicated), fulfilling specific clinical and echocardiographic criteria.