Treatment of Acute Mitral Regurgitation in Severe Primary Mitral Regurgitation
Clinical Scenario
This protocol addresses acute mitral regurgitation arising in the setting of severe primary mitral regurgitation — specifically in low-risk asymptomatic patients without left ventricular dysfunction where intervention timing is a critical clinical question.
Treatment Approach
In this scenario, the management approach centres on surgical mitral valve repair when specific criteria are met and a durable result is anticipated. At experienced centres, a minimally invasive surgical approach may also form part of the strategy.
The complete criteria, patient selection thresholds, and full procedural pathway are available in the structured protocol below.
References
DOI: 10.1093/eurheartj/ehaf194
Surgical MV repair is recommended in low-risk asymptomatic patients with severe PMR without LV dysfunction (LVESD <40 mm, LVESDi <20 mm/m², and LVEF >60%) when a durable result is likely, if at least three of the following criteria are fulfilled:
Minimally invasive MV surgery may be considered at experienced centres to reduce the length of stay and accelerate recovery.
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