When to Intervene for Asymptomatic Mitral Valve Regurgitation

Yan Topilsky, Rakesh Suri, Hartzell V. Schaff, Maurice Enriquez-Sarano

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Mitral regurgitation (MR), currently the most frequent valvular heart disease, is mostly degenerative, linked to aging and of increasing prevalence. Indications of mitral surgery, the only current approved treatment of MR, are disputed. Coherent cumulative evidence obtained worldwide show that early surgery in asymptomatic patients is the preferred approach. Waiting for symptoms or left ventricular dysfunction is a failed strategy in that these characteristics are insensitive markers of risk, are often unrecognized in a timely manner and, even after successful surgery, are associated with poor outcome. Furthermore, in patients with severe organic MR, surgery is almost unavoidable and early mitral repair before the appearance of symptoms or overt LV dysfunction may restore life expectancy as long as valve repair is performed. New objective markers of adverse outcome under medical management have recently been described, allowing selection of patients for performance of restorative surgery that reestablishes life expectancy. This approach of early surgery provides improved outcomes in observational studies and is conceivable in centers that provide low risk, high repair rates, high quality of repairs and of Doppler-Echocardiographic assessment.

Original languageEnglish (US)
Pages (from-to)216-224
Number of pages9
JournalSeminars in thoracic and cardiovascular surgery
Volume22
Issue number3
DOIs
StatePublished - Dec 20 2010

Keywords

  • Effective regurgitant orifice
  • Mitral regurgitation
  • Mitral valve repair

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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