Mitral Valve Prolapse with Severe Primary Mitral Regurgitation and Normal Left Ventricular Ejection Fraction (Stage C1, Asymptomatic)
This protocol addresses the management of asymptomatic mitral valve prolapse presenting with severe primary mitral regurgitation at Stage C1, where left ventricular systolic function remains preserved.
Clinical Scenario
The patient is asymptomatic with severe primary mitral regurgitation (Stage C1) and normal left ventricular systolic function — specifically, a left ventricular ejection fraction greater than 60% and a left ventricular end-systolic dimension less than 40 mm. Despite the absence of symptoms, the severity of the regurgitation and the preserved but borderline ventricular parameters define a distinct management situation.
Treatment Approach
A surgical intervention targeting the valve itself is a central consideration in this scenario — but the suitability depends on specific procedural likelihood criteria and the level of the treating centre.
Full criteria, conditions, and the complete structured regimen are in the protocol →
References
In asymptomatic patients with severe primary MR and normal LV systolic function (LVEF ≥60% and LVESD ≤40 mm) (Stage C1), mitral valve repair is reasonable when the likelihood of a successful and durable repair without residual MR is >95% with an expected mortality rate of <1%, when it can be performed at a Primary or Comprehensive Valve Center.
DOI: 10.1161/CIR.0000000000000923
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