ESC Valve guidelines

Question 1

When is surgery recommended in asymptomatic severe primary MR?

Answer 1

Surgery is recommended in asymptomatic
patients with LV dysfunction (LVESD >_40 mm
and/or LVEF <_60%)

Surgery should be considered in asymptomatic
patients with preserved LV function (LVESD
<40 mm and LVEF >60%) and AF secondary to
mitral regurgitation or pulmonary hypertension
(SPAP at rest >50 mmHg)

Surgical mitral valve repair should be considered
in low-risk asymptomatic patients with LVEF
>60%, LVESD <40 mmd and significant LA dilatation (volume index >_60 mL/m2 or diameter
>_55 mm) when performed in a Heart Valve
Centre and a durable repair is likely

TEER may be considered in symptomatic
patients who fulfil the echocardiographic criteria
of eligibility, are judged inoperable or at high surgical risk by the Heart Team and for whom the
procedure is not considered futile