2020 Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation: A Report of the American College of Cardiology Solution Set Oversight Committee

J Am Coll Cardiol. 2020 May 5;75(17):2236-2270. doi: 10.1016/j.jacc.2020.02.005. Epub 2020 Feb 14.

Abstract

Mitral regurgitation (MR) is a complex valve lesion that can pose significant management challenges. This expert consensus decision pathway emphasizes that recognition of MR should prompt an assessment of its etiology, mechanism, and severity, as well as consideration of the indications for treatment. The document is a focused update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation, with some sections updated and others added in light of the publication of new trial data related to secondary MR, among other developments. A structured approach to evaluation based on clinical findings, accurate echocardiographic imaging, and, when necessary, adjunctive testing can help clarify decision making. Treatment goals include timely intervention by an experienced multidisciplinary heart team to prevent left ventricular dysfunction, heart failure, reduced quality of life, and premature death.

Keywords: ACC Expert Consensus Decision Pathway; heart failure; mitral regurgitation; mitral valve; registry; transcatheter mitral valve repair; transcatheter mitral valve replacement.

Publication types

  • Practice Guideline

MeSH terms

  • Advisory Committees / standards*
  • Cardiac Catheterization / methods
  • Cardiac Catheterization / standards
  • Cardiology / methods
  • Cardiology / standards*
  • Consensus*
  • Disease Management*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis Implantation / standards
  • Humans
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / epidemiology
  • Mitral Valve Insufficiency / therapy*
  • Research Report / standards*
  • United States / epidemiology