Timing of surgery in organic mitral regurgitation
| Prompt mitral surgery decision | |
|---|---|
| AF, atrial fibrillation; LV, left ventricle; MR, mitral regurgitation; PHTN, pulmonary hypertension; VT, ventricular tachycardia. | |
| Severe mitral regurgitation | |
| Symptoms or LV dysfunction present | Yes |
| No symptoms and n LV dysfunction | |
| AF or VT or PHTN | Yes |
| No AF, no VT, no PHTN | |
| Repairable = No | Usually no |
| Massive MR (regurgitant volume ≥100 ml) | Possible yes |
| Pronounced left atrial enlargement | |
| Repairable = Yes and | |
| Low risk | Usually yes |
| High risk or severe comorbidity | Usually no |
| Not severe mitral regurgitation | |
| Regurgitant volume <45 ml | No |
| Regurgitant volume 45–60 ml | Usually no |
| VT or AF or LV dysfunction and repairable = yes | Possible yes |
| Other cardiac operation scheduled and repairable = yes | Possible yes |