{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:33:51Z","timestamp":1773916431072,"version":"3.50.1"},"reference-count":39,"publisher":"Elsevier BV","issue":"6-7","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"vor","delay-in-days":366,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Archives of Cardiovascular Diseases"],"published-print":{"date-parts":[[2019,6]]},"DOI":"10.1016\/j.acvd.2019.04.003","type":"journal-article","created":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T20:01:52Z","timestamp":1559160112000},"page":"430-440","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pathophysiology and management of combined aortic and mitral regurgitation"],"prefix":"10.1016","volume":"112","author":[{"given":"Philippe","family":"Unger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizio","family":"Lancellotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Amzulescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelia","family":"David-Cojocariu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"de Canni\u00e8re","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.acvd.2019.04.003_bib0200","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"10.1016\/j.acvd.2019.04.003_bib0205","doi-asserted-by":"crossref","first-page":"e1159","DOI":"10.1161\/CIR.0000000000000503","article-title":"2017 AHA\/ACC focused update of the 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"135","author":"Nishimura","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0210","doi-asserted-by":"crossref","first-page":"e007862","DOI":"10.1161\/CIRCIMAGING.118.007862","article-title":"Multiple and Mixed Valvular Heart Diseases","volume":"11","author":"Unger","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.acvd.2019.04.003_bib0215","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.amjcard.2006.10.048","article-title":"Prevalence and clinical correlates of isolated mitral, isolated aortic regurgitation, and both in adults aged 21 to 35 years (from the CARDIA study)","volume":"99","author":"Reid","year":"2007","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0220","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/S0002-9149(98)01064-9","article-title":"Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)","volume":"83","author":"Singh","year":"1999","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0225","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1161\/CIRCULATIONAHA.109.927921","article-title":"Prognostic implications of mitral regurgitation in patients with severe aortic regurgitation","volume":"122","author":"Pai","year":"2010","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0230","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1136\/heartjnl-2016-310894","article-title":"Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study","volume":"103","author":"Andell","year":"2017","journal-title":"Heart"},{"key":"10.1016\/j.acvd.2019.04.003_bib0235","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.cpcardiol.2007.07.002","article-title":"Valvular heart disease in the community: a European experience","volume":"32","author":"Iung","year":"2007","journal-title":"Curr Probl Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0240","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.jacc.2007.06.024","article-title":"Insights into degenerative aortic valve disease","volume":"50","author":"Goldbarg","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0245","first-page":"107","article-title":"Risk of valvular heart disease after treatment for Hodgkin lymphoma","author":"Cutter","year":"2015","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.acvd.2019.04.003_bib0250","doi-asserted-by":"crossref","first-page":"3580","DOI":"10.1093\/eurheartj\/eht266","article-title":"Frequency of drug-induced valvular heart disease in patients previously exposd to benfluorex: a multicentre prospective study","volume":"34","author":"Tribouilloy","year":"2013","journal-title":"Eur Heart J"},{"key":"10.1016\/j.acvd.2019.04.003_bib0255","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/MD.0b013e318225dcb0","article-title":"Multiple-valve infective endocarditis: clinical, microbiologic, echocardiographic, and prognostic profile","volume":"90","author":"Lopez","year":"2011","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.acvd.2019.04.003_bib0260","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1016\/j.jacc.2013.01.064","article-title":"Mitral valve enlargement in chronic aortic regurgitation as a compensatory mechanism to prevent functional mitral regurgitation in the dilated left ventricle","volume":"61","author":"Beaudoin","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0265","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.jtcvs.2013.09.030","article-title":"Management of concomitant mild to moderate functional mitral regurgitation during aortic valve surgery for severe aortic insufficiency","volume":"148","author":"Lim","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0270","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/S0735-1097(84)80349-6","article-title":"Differences in myocardial performance and load between patients with similar amounts of chronic aortic versus chronic mitral regurgitation","volume":"3","author":"Wisenbaugh","year":"1984","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0275","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.jacc.2004.03.061","article-title":"Is it ever too late to operate on the patient with valvular heart disease?","volume":"44","author":"Carabello","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0280","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/j.athoracsur.2015.06.009","article-title":"Ventricular function before and after surgery for isolated and combined regurgitation in the young","volume":"100","author":"Gentles","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0285","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/0002-9149(90)91330-9","article-title":"Preoperative left and right ventricular performance in combined aortic and mitral regurgitation and comparison with isolated aortic or mitral regurgitation","volume":"65","author":"Niles","year":"1990","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0290","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.echo.2017.01.007","article-title":"Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the american society of echocardiography developed in collaboration with the society for cardiovascular magnetic resonance","volume":"30","author":"Zoghbi","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.acvd.2019.04.003_bib0295","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1161\/CIR.0b013e3181d44a8f","article-title":"ACCF\/ACR\/AHA\/NASCI\/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents","volume":"121","author":"Hundley","year":"2010","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0300","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1161\/CIRCULATIONAHA.107.742486","article-title":"Cardiovascular magnetic resonance imaging for valvular heart disease: technique and validation","volume":"119","author":"Cawley","year":"2009","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0305","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jcmg.2017.02.016","article-title":"Incremental prognostic utility of left ventricular global longitudinal strain in asymptomatic patients with significant chronic aortic regurgitation and preserved left ventricular ejection fraction","volume":"11","author":"Alashi","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.acvd.2019.04.003_bib0310","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/j.jcmg.2018.04.011","article-title":"The Prognostic Role of Global Longitudinal Strain in Severe Primary Mitral Regurgitation: Moving Past the Proof-of-Concept Era","volume":"11","author":"Thomas","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.acvd.2019.04.003_bib0315","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1161\/01.CIR.95.4.899","article-title":"Time-related changes in left ventricular function after double valve replacement for combined aortic and mitral regurgitation in a young rheumatic population. Predictors of postoperative left ventricular performance and role of chordal preservation","volume":"95","author":"Skudicky","year":"1997","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0320","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/S0195-668X(03)00201-X","article-title":"A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease","volume":"24","author":"Iung","year":"2003","journal-title":"Eur Heart J"},{"key":"10.1016\/j.acvd.2019.04.003_bib0325","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/imi.0000000000000028","article-title":"Outcome characteristics of multiple-valve surgery: comparison with single-valve procedures","volume":"9","author":"Vassileva","year":"2014","journal-title":"Innovations (Phila)"},{"key":"10.1016\/j.acvd.2019.04.003_bib0330","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJM199507063330103","article-title":"Optimal oral anticoagulant therapy in patients with mechanical heart valves","volume":"333","author":"Cannegieter","year":"1995","journal-title":"N Engl J Med"},{"key":"10.1016\/j.acvd.2019.04.003_bib0335","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1038\/nrcardio.2016.57","article-title":"Pathophysiology and management of multivalvular disease","volume":"13","author":"Unger","year":"2016","journal-title":"Nat Rev Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0340","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1161\/CIRCULATIONAHA.115.015371","article-title":"Clinical impact of changes in left ventricular function after aortic valve replacement: analysis from 3112 patients","volume":"132","author":"Une","year":"2015","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0345","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/0002-9149(94)90826-5","article-title":"Discordant changes in left ventricular performance after valve replacement for isolated rheumatic mitral regurgitation versus combined mitral and aortic regurgitation in teenagers","volume":"73","author":"Essop","year":"1994","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0350","first-page":"1085","article-title":"Long-term results after concomitant mitral and aortic valve surgery: repair or replacement?","volume":"54","author":"Coutinho","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0355","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/S0022-5223(02)73225-X","article-title":"Mitral valve repair with aortic valve replacement is superior to double valve replacement","volume":"125","author":"Gillinov","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0360","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0003-4975(02)04405-3","article-title":"Durability and outcome of aortic valve replacement with mitral valve repair versus double valve replacement","volume":"75","author":"Hamamoto","year":"2003","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0365","doi-asserted-by":"crossref","first-page":"S155","DOI":"10.1161\/CIRCULATIONAHA.108.843573","article-title":"Outcomes of patients undergoing concomitant aortic and mitral valve surgery in northern New England","volume":"120","author":"Leavitt","year":"2009","journal-title":"Circulation"},{"key":"10.1016\/j.acvd.2019.04.003_bib0370","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S0003-4975(01)02677-7","article-title":"Durability of combined aortic and mitral valve repair","volume":"72","author":"Gillinov","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.acvd.2019.04.003_bib0375","first-page":"728","article-title":"Benefit of the MitraClip for mitral regurgitation","volume":"15","author":"Lim","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0380","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1002\/clc.23103","article-title":"Transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation: A systematic review and meta-analysis","volume":"42","author":"Haddad","year":"2019","journal-title":"Clin Cardiol"},{"key":"10.1016\/j.acvd.2019.04.003_bib0385","first-page":"124","article-title":"A systematic review of reported cases of combined transcatheter aortic and mitral valve interventions","volume":"91","author":"Ando","year":"2018","journal-title":"Catheter Cardiovasc Interv"},{"key":"10.1016\/j.acvd.2019.04.003_bib0390","doi-asserted-by":"crossref","first-page":"e430","DOI":"10.1161\/CIRCULATIONAHA.114.014023","article-title":"One-stage off-pump transapical mitral valve repair and aortic valve replacement","volume":"131","author":"Gerosa","year":"2015","journal-title":"Circulation"}],"container-title":["Archives of Cardiovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1875213619300968?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1875213619300968?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:45:13Z","timestamp":1761745513000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1875213619300968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":39,"journal-issue":{"issue":"6-7","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["S1875213619300968"],"URL":"https:\/\/doi.org\/10.1016\/j.acvd.2019.04.003","relation":{},"ISSN":["1875-2136"],"issn-type":[{"value":"1875-2136","type":"print"}],"subject":[],"published":{"date-parts":[[2019,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pathophysiology and management of combined aortic and mitral regurgitation","name":"articletitle","label":"Article Title"},{"value":"Archives of Cardiovascular Diseases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.acvd.2019.04.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Masson SAS.","name":"copyright","label":"Copyright"}]}}