Class I (evidence and/or general agreement that surgery is useful and effective)
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▸ Symptoms caused by mitral regurgitation (acute or chronic) |
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▸ Asymptomatic patients with severe MR and mild-moderate LV dysfunction defined as an: |
–ejection fraction 30–60% and |
–end systolic dimension 45–55 mm |
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Class IIa (conflicting evidence and/or divergence of opinion but the weight of evidence/opinion favours surgical intervention)
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▸ Asymptomatic patients with normal LV function and |
–atrial fibrillation or |
–pulmonary hypertension (>50 mm Hg at rest or >60 mm Hg with exercise) |
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▸ Asymptomatic patients with |
–ejection fraction 50–60% or |
–end systolic dimension 45–55 mm |
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▸ Severe left ventricular systolic dysfunction (ejection fraction <30% and/or end systolic dimension >55 mm) if chordal preservation is highly likely |