Functional Mitral Regurgitation: Imaging Insights, Clinical Outcomes and Surgical Principles

Functional mitral regurgitation (MR; FMR) is the most common type of MR and its development is associated with increased morbidity and mortality. Leaflet tethering with apical shift of the papillary muscle due to adverse left ventricular remodeling and loss of normal leaflet coaptation is the principal mechanism of FMR. Echocardiography plays a central role in the assessment of the FMR. The development of 3D echocardiography has allowed for assessment of the geometric changes of mitral valve morphology and spatial relationship with the left ventricle that accompanies FMR. 2D/3D echocardiographic findings, clinical outcomes of FMR are reviewed and role of surgical intervention is discussed.