Mitral valve repair for severe mitral regurgitation: the way forward?

Abstract:

:Severe primary mitral regurgitation (MR) has a poor outcome if left uncorrected. Successful mitral valve repair has the unique potential to restore normal life expectancy and is superior to valve replacement. Despite this, mitral repair is performed relatively infrequently and many patients with potentially reparable valves have a replacement instead, subjecting them to unnecessary risk. Surgery in asymptomatic patients is a particularly difficult issue with some units advocating surgery irrespective of symptoms, based purely on the severity of regurgitation. This strategy cannot be widely adopted with the current patchy provision of high-quality valve repair surgery. Misplaced enthusiasm for early operation runs the risk of a failed repair and the hazards of a mechanical prosthesis. To ensure optimal treatment for patients with MR, cardiologists must be aware of the indications for valve repair and ensure that patients with potentially reparable valves are referred to surgeons with proven expertise, even if this means a shift from established practice. Surgical units need to promote subspecialization and rigorously audit their outcomes. There are currently no agreed standards for best practice in mitral valve repair and this is an area where professional societies may wish to take a role.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Ray S,Chambers J,Gohlke-Baerwolf C,Bridgewater B

doi

10.1093/eurheartj/ehl381

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

2925-8

issue

24

eissn

0195-668X

issn

1522-9645

pii

ehl381

journal_volume

27

pub_type

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