TY - JOUR
T1 - Mitral valve repair in asymptomatic patients with severe mitral regurgitation
T2 - Pushing past the tipping point
AU - Suri, Rakesh M.
AU - Schaff, Hartzell V.
AU - Enriquez-Sarano, Maurice
N1 - Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2014
Y1 - 2014
N2 - Degenerative mitral valve regurgitation (MR) is the one of the most frequent valvular heart conditions in the Western world and is increasingly recognized as an important preventable cause of chronic heart failure. This condition also represents the most common indication for mitral surgery and is of particular interest because the mitral valve can be repaired in most patients with very low surgical risk. Historical single-center studies have supported the performance of "early mitral valve repair" in asymptomatic patients with severe degenerative MR to normalize survival and improve late outcomes. Emerging recent evidence further indicates for the first time that the prompt surgical correction of severe MR due to flail mitral leaflets within 3 months following diagnosis in asymptomatic patients without classical Class I indications (symptoms or left ventricular dysfunction) conveys a 40% decrease in the risk of late death and a 60% diminution in heart failure incidence. A 10-point rationale based on the weight of rapidly accumulating clinical data, supports the performance of early mitral valve repair even in the absence of symptoms, left ventricular dysfunction, or guideline-based triggers; when effective operations can be provided using conventional or minimally invasive techniques at very low surgical risk.
AB - Degenerative mitral valve regurgitation (MR) is the one of the most frequent valvular heart conditions in the Western world and is increasingly recognized as an important preventable cause of chronic heart failure. This condition also represents the most common indication for mitral surgery and is of particular interest because the mitral valve can be repaired in most patients with very low surgical risk. Historical single-center studies have supported the performance of "early mitral valve repair" in asymptomatic patients with severe degenerative MR to normalize survival and improve late outcomes. Emerging recent evidence further indicates for the first time that the prompt surgical correction of severe MR due to flail mitral leaflets within 3 months following diagnosis in asymptomatic patients without classical Class I indications (symptoms or left ventricular dysfunction) conveys a 40% decrease in the risk of late death and a 60% diminution in heart failure incidence. A 10-point rationale based on the weight of rapidly accumulating clinical data, supports the performance of early mitral valve repair even in the absence of symptoms, left ventricular dysfunction, or guideline-based triggers; when effective operations can be provided using conventional or minimally invasive techniques at very low surgical risk.
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U2 - 10.1053/j.semtcvs.2014.07.004
DO - 10.1053/j.semtcvs.2014.07.004
M3 - Article
C2 - 25441000
AN - SCOPUS:84927601555
VL - 26
SP - 95
EP - 101
JO - Seminars in Thoracic and Cardiovascular Surgery
JF - Seminars in Thoracic and Cardiovascular Surgery
SN - 1043-0679
IS - 2
ER -