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Current Advances in Valvular Heart Diseases
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Current Advances in Valvular Heart Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 March 2025) | Viewed by 2971

Special Issue Editor

Dr. Vuyisile T. Nkomo

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, Mayo Medical School, Rochester, MN 55905, USA
Interests: valvular heart disease; valvular heart disease epidemiology; echocardiography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Valvular heart diseases are a major public health problem associated with an increased risk of morbidity and mortality when not treated. Over the last decade, there has been a growing appreciation for the importance of the underlying mechanism of valvular heart disease and imaging, and the independent association of tricuspid valve regurgitation to reduced survival. Early and timely valvular heart disease intervention is associated with improved outcomes. However, due to their silent nature, valvular heart diseases frequently go underdiagnosed or are diagnosed late, often leading to no intervention or delayed intervention.

This Special Issue highlights strategies for the early diagnosis of valvular heart disease, such as machine learning or artificial intelligence, and the broadening understanding of mechanisms of valvular heart disease and their impact on the type and timing of intervention. 

The topics of interest for this Special Issue include, but are not limited to, the following:

  1. Machine learning and artificial intelligence applications in valvular heart disease;
  2. Evaluation and management of primary and secondary mitral regurgitation;
  3. Evaluation and management of primary and secondary tricuspid valve regurgitation;
  4. Transcatheter valve therapies for aortic, mitral, and tricuspid valve disease;
  5. Minimally invasive surgical strategies for the treatment of valvular heart disease.

Dr. Vuyisile T. Nkomo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • valve disease
  • aortic valve stenosis
  • aortic valve regurgitation
  • mitral valve stenosis
  • mitral valve regurgitation
  • mitral annular calcification
  • tricuspid valve regurgitation
  • machine learning
  • artificial intelligence
  • echocardiography

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Published Papers (5 papers)

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Research

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11 pages, 1646 KiB  
Article
Understanding Surgical Management and Outcomes in Mitral Valve Endocarditis
by Elda Dzilic, Samuel Niedermayer, Melchior Burri, Andrea Amabile, Markus Krane and Keti Vitanova
J. Clin. Med. 2025, 14(8), 2712; https://doi.org/10.3390/jcm14082712 - 15 Apr 2025
Viewed by 256
Abstract
Objectives: Surgical patients with mitral valve endocarditis can be treated with valve reconstruction or valve replacement. Although valve repair should be preferred, the decision between the two options is nuanced. Methods: In this single-center, retrospective cohort study, we included all patients [...] Read more.
Objectives: Surgical patients with mitral valve endocarditis can be treated with valve reconstruction or valve replacement. Although valve repair should be preferred, the decision between the two options is nuanced. Methods: In this single-center, retrospective cohort study, we included all patients who underwent surgery for native mitral valve endocarditis between February 2001 and June 2019. We analyzed the surgical outcomes, survival, and factors leading to valve repair versus replacement. Propensity score matching was performed to minimize treatment assignment bias and improve comparability between the two groups. Results: This study included 281 consecutive patients with mitral valve endocarditis, of whom 46 (16.4%) underwent mitral valve repair and 235 (83.6%) underwent mitral valve replacement. The mean follow-up was 5.2 ± 5.1 years. Cases with bileaflet endocarditis (p < 0.001), subvalvular apparatus involvement (p = 0.008), and abscess formation (p = 0.047) were more likely to require valve replacement. The 30-day mortality rate was 12.1% (n = 34). Patients who underwent repair had significantly better survival than those who underwent replacement (92.7% ± 4.1% vs. 59.4% ± 3.4% at 5 years; p < 0.001), even after propensity score matching (92.6% ± 5.0% vs. 62.4% ± 9.0% at 5 years; p = 0.034). Conclusions: In patients with mitral valve endocarditis, mitral valve repair had better long-term survival, even after propensity score matching, highlighting the potential benefit of valve preservation techniques. Full article
(This article belongs to the Special Issue Current Advances in Valvular Heart Diseases)
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17 pages, 728 KiB  
Article
Single-Centre Experience with the Balloon-Expandable Myval Transcatheter Aortic Valve System with the First 200 Patients: 30-Day and 1-Year Follow-Up
by Bálint Kittka, Balázs Magyari, Ilona Goják, Gábor Kasza, Kristóf Schönfeld, László Botond Szapáry, Mihály Simon, Rudolf Kiss, Andrea Bertalan, Edit Várady, István Szokodi and Iván Gábor Horváth
J. Clin. Med. 2025, 14(7), 2323; https://doi.org/10.3390/jcm14072323 - 28 Mar 2025
Viewed by 306
Abstract
Aims: The aim of this paper is to report 30-day and 1-year outcome data regarding the first 200 patients who underwent the TAVR procedure using the Myval THV system at our single centre. Methods: From November 2019 to October 2022, 200 [...] Read more.
Aims: The aim of this paper is to report 30-day and 1-year outcome data regarding the first 200 patients who underwent the TAVR procedure using the Myval THV system at our single centre. Methods: From November 2019 to October 2022, 200 consecutive patients underwent TAVR procedure. Outcomes were analysed according to the VARC-2 definitions, and device performance was assessed via transthoracic echocardiography. Data collection was approved by the local Ethical Committee. Results: The mean age of the cohort was 75.3 ± 6.9 years, and 122 (61%) participants were male. The mean EuroSCORE II and STS was 5.4 ± 5.4 and 5.8 ± 3.8, respectively. The proportion of patients with a bicuspid aortic valve was 18%. The transfemoral access approach was the most common (surgical vs. percutaneous: 1% vs. 98%), and in two patients, surgical subclavian access was used. VARC-2 outcomes were as follows: 99% device success, 2% STROKE, 5% and 4.5% major and minor vascular complications, respectively, and a 29.5% rate of new permanent pacemaker implantation. At discharge, the incidence of aortic regurgitation grade II or above was 5.5% without relevant PVL (grade II or above 0.5%). In-hospital mortality was only 1%. At 1 year, the all-cause mortality rate was 8.5% (cardiac origin in three cases), and two patients had valve-related dysfunction requiring surgical aortic replacement. Conclusions: Our results showed excellent 30-day and 1-year outcomes regarding patient survival, technical success, and valve-related adverse events using the Myval transcatheter heart valve system. The limitations of our study comprise a single-centre design with retrospective data collection. Full article
(This article belongs to the Special Issue Current Advances in Valvular Heart Diseases)
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10 pages, 3299 KiB  
Article
Concomitant Transcatheter Edge-to-Edge Repair and Left Atrial Appendage Occlusion
by Graeme Prosperi-Porta, Adam Dryden, Donna Nicholson, Mark Hynes, Vincent Chan, Richard G. Jung, Pietro Di Santo, Trevor Simard, Marino Labinaz, Benjamin Hibbert and Omar Abdel-Razek
J. Clin. Med. 2025, 14(7), 2257; https://doi.org/10.3390/jcm14072257 - 26 Mar 2025
Viewed by 324
Abstract
Background/Objectives: Atrial fibrillation is a frequent comorbidity amongst patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation. Left atrial appendage occlusion (LAAO) can be performed to reduce the risk of stroke in patients with atrial fibrillation. Both procedures require large-bore [...] Read more.
Background/Objectives: Atrial fibrillation is a frequent comorbidity amongst patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation. Left atrial appendage occlusion (LAAO) can be performed to reduce the risk of stroke in patients with atrial fibrillation. Both procedures require large-bore venous access, transseptal puncture, and real-time imaging of the left atrium. However, limited data exist evaluating the safety and feasibility of concomitant M-TEER and LAAO. Methods: We performed a retrospective review of all concomitant M-TEER and LAAO procedures at our institution between May 2019 and September 2024 to evaluate the safety and feasibility of this approach. Results: Concomitant left atrial appendage occlusion was successful in all 15 patients, requiring an additional 15 min (IQR 11–29) of procedural time. No patients died or had a major vascular complication. Routine transesophageal echocardiography performed within 90 days showed no device related thrombus, and no significant peri-device leak in any patients. Conclusions: Concomitant M-TEER and LAAO are feasible but additional prospective studies or randomized trials are needed to evaluate the potential clinical benefit. Full article
(This article belongs to the Special Issue Current Advances in Valvular Heart Diseases)
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Review

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22 pages, 1650 KiB  
Review
Long-Term Outcomes of Surgical and Transcatheter Interventions for Tricuspid Regurgitation: A Comprehensive Review
by Vasiliki Tasouli-Drakou, Ibrahim Youssef, Arsalan Siddiqui and Tahir Tak
J. Clin. Med. 2025, 14(7), 2451; https://doi.org/10.3390/jcm14072451 - 3 Apr 2025
Viewed by 648
Abstract
Impacting more than 70 million people worldwide, tricuspid regurgitation (TR) refers to the retrograde flow of blood from the right ventricle to the right atrium due to the improper closure of the tricuspid valve. Depending on the severity of TR, signs and symptoms [...] Read more.
Impacting more than 70 million people worldwide, tricuspid regurgitation (TR) refers to the retrograde flow of blood from the right ventricle to the right atrium due to the improper closure of the tricuspid valve. Depending on the severity of TR, signs and symptoms can range from asymptomatic to features of right heart failure, including dyspnea, exercise intolerance, peripheral edema, and ascites. Severe features such as these necessitate treatment. In recent years, advancements in management, including surgical and transcatheter interventions, have taken prominence, leading to improved short-term outcomes in this patient population. However, there is still a dearth of evidence regarding the long-term outcomes of surgical and transcatheter interventions for TR. This comprehensive review aims to present clinicians with recent findings from pivotal clinical studies on interventional clinical outcomes in an effort to help guide their judgment when it comes to deciding the best course of treatment for their patients. Full article
(This article belongs to the Special Issue Current Advances in Valvular Heart Diseases)
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Other

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19 pages, 1762 KiB  
Systematic Review
The Prevalence, Pathophysiological Role and Determinants of Mitral Annular Disjunction Among Patients with Mitral Valve Prolapse: A Systematic Review
by Andrea Sonaglioni, Gian Luigi Nicolosi, Giovanna Elsa Ute Muti-Schünemann, Michele Lombardo and Paola Muti
J. Clin. Med. 2025, 14(5), 1423; https://doi.org/10.3390/jcm14051423 - 20 Feb 2025
Cited by 1 | Viewed by 831
Abstract
Background: Over the last two decades, a number of imaging studies have evaluated the characteristics and clinical implications of mitral annular disjunction (MAD) among patients with mitral valve prolapse (MVP). The present systematic review has been primarily designed to summarize the main findings [...] Read more.
Background: Over the last two decades, a number of imaging studies have evaluated the characteristics and clinical implications of mitral annular disjunction (MAD) among patients with mitral valve prolapse (MVP). The present systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall impact of MAD in MVP patients. Methods: All imaging studies assessing the prevalence, pathophysiological role and determinants of MAD in MVP individuals, selected from the PubMed and EMBASE databases, were included. There was no limitation in terms of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 23 studies on 7718 MVP individuals were analyzed. The overall pooled prevalence of MAD in MVP individuals was 40% (range 5.4–90%). When considering the different imaging modalities for assessing MAD, the average MAD prevalence was 20% for cardiac computed tomography studies, 31.3% for transthoracic echocardiography (TTE) studies, 44.7% for transesophageal echocardiography studies and 47% for cardiac magnetic resonance studies. MAD presence was more commonly associated with female sex, young age, narrow antero-posterior thoracic diameter, symptoms of palpitations and syncope, T-wave inversion in inferolateral leads and frequent and/or complex ventricular arrhythmias (VAs) on electrocardiogram, myxomatous leaflets, bileaflet prolapse, larger mitral valve annulus and non-severe mitral regurgitation on TTE. A total of 12 studies (52.2%) provided follow-up data. Over a median follow-up time of 3.9 yrs (range 1–10.3 yrs), MVP individuals with MAD showed increased risk of clinical arrhythmic events, no difference in survival rate and good surgical outcomes. Conclusions: MAD was present in more than one-third of MVP patients, with a wide range of variability depending on the specific imaging method used for assessing MAD presence and on a nonunivocal MAD definition, with a possible overestimation due to Pseudo-MAD rather than True-MAD measurement. A multimodality imaging approach comprehensive of noninvasive chest shape assessment might improve MAD detection among MVP individuals. It appears that careful serial monitoring for VAs should be mandatory for MAD patients. Full article
(This article belongs to the Special Issue Current Advances in Valvular Heart Diseases)
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