Optimal Timing of Surgery of Mitral Regurgitation / 한양의대학술지

ABSTRACT

Mitral regurgitation is a progressive disease that may lead to left ventricular dysfunction. Medical treatment is of limited value in chronic progressive mitral regurgitation except in those with comorbid hypertension or LV dysfunction. Recent advances in surgical techniques has changed the roles of medical and surgical therapies. Therefore the prime importance of treating physicians is to identify the optimal timing ofsurgery in this population. Two important factors should be taken into consideration while deciding the optimal timing of surgical intervention. One is functional cardiac status and the other is the left ventricular response to volume overload. Besides, the pathologic nature of mitral regurgitation, the severity of mitral regurgitation, the possibility of successful mitral repair, the development of atrial fibrillation and the presence of pulmonary hypertension, together with the hemodynamic response to exercise. Advances in the understanding of natural pathophysiologic nature of progressive mitral regurgitation and successful technical surgical repair have extended the role of early surgical intervention even in asymptomaticpatients with normal LV function.