TY - JOUR
T1 - Mitral regurgitation
T2 - A new clinical perspective
AU - Enriquez-Sarano, Maurice
AU - Orszulak, Thomas A.
AU - Schaff, Hartzell V.
AU - Abel, Martin D.
AU - Jamil Tajik, A.
AU - Frye, Robert L.
AU - Anesthesiology, Department Of
AU - Rochester, Mayo Clinic
N1 - Funding Information:
This study was supported by National Key Basic Research Program of China (NO. 2014CB239203), National Natural Science Foundation of China (No. 51474158, No. 51504166), and Program for New Century Excellent Talents in University of Ministry of Education (Grant No: NCET-12-0424).
PY - 1997
Y1 - 1997
N2 - Mitral regurgitation is a common valvular heart disease, particularly in the elderly population. The timing of surgical repair is controversial, but recent literature suggests a new clinical perspective on the management of this disease. Despite receiving medical treatment and having few initial symptoms, patients with mitral regurgitation due to flail leaflets have an excess mortality rate (6.3% per year) and high morbidity. Ten years after mitral regurgitation has been diagnosed, 90% of the patients have either died or undergone an operation. After surgical correction of mitral regurgitation, left ventricular dysfunction is a frequent complication and is the cause of excess heart failure and mortality. This complication is due to preoperative left ventricular dysfunction but is incompletely predictable with use of current methods. Conversely, considerable progress in surgery has resulted in an extremely low operative mortality rate (about 1% in patients younger than 75 years of age) and high feasibility of valve repair, even in patients with anterior leaflet prolapse. These facts have led to the new perspective that early surgical correction (before occurrence of overt symptoms or left ventricular dysfunction) should be considered when patients are diagnosed with severe mitral regurgitation.
AB - Mitral regurgitation is a common valvular heart disease, particularly in the elderly population. The timing of surgical repair is controversial, but recent literature suggests a new clinical perspective on the management of this disease. Despite receiving medical treatment and having few initial symptoms, patients with mitral regurgitation due to flail leaflets have an excess mortality rate (6.3% per year) and high morbidity. Ten years after mitral regurgitation has been diagnosed, 90% of the patients have either died or undergone an operation. After surgical correction of mitral regurgitation, left ventricular dysfunction is a frequent complication and is the cause of excess heart failure and mortality. This complication is due to preoperative left ventricular dysfunction but is incompletely predictable with use of current methods. Conversely, considerable progress in surgery has resulted in an extremely low operative mortality rate (about 1% in patients younger than 75 years of age) and high feasibility of valve repair, even in patients with anterior leaflet prolapse. These facts have led to the new perspective that early surgical correction (before occurrence of overt symptoms or left ventricular dysfunction) should be considered when patients are diagnosed with severe mitral regurgitation.
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U2 - 10.4065/72.11.1034
DO - 10.4065/72.11.1034
M3 - Article
C2 - 9374977
AN - SCOPUS:0030830539
SN - 0025-6196
VL - 72
SP - 1034
EP - 1043
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 11
ER -