This protocol addresses management of chronic severe primary mitral regurgitation — structural valve disease requiring patient-specific assessment to determine the appropriate intervention strategy, whether asymptomatic or symptomatic.
Indications for intervention differ between asymptomatic and symptomatic presentations of chronic severe primary mitral regurgitation. The individual patient's anatomy, symptoms, and risk profile all inform the choice of treatment pathway.
For selected high-risk patients — particularly those whose valve anatomy makes certain catheter-based repair techniques less suitable — a transcatheter implantation approach may be an option. Very frail patients represent a distinct subgroup with a different management consideration. The complete treatment algorithm, selection criteria, and sequencing are available in the full protocol.
DOI: 10.1093/eurheartj/ehaf194