More Evidence for Early Surgery for Asymptomatic Primary Mitral Regurgitation

A Korean registry study provides valuable long-term outcomes data in a large cohort, although important limitations constrain its impact on clinical practice.

Management of severe primary (degenerative) mitral regurgitation (MR) in asymptomatic patients with preserved left ventricular function is controversial. Current U.S. and European guidelines differ on whether to recommend surgery when repair is likely or to pursue a watchful-waiting strategy. To address this disagreement, investigators used registry data to compare outcomes in 235 patients undergoing early surgery and 375 patients treated conventionally at two centers in Korea between 1996 and 2009. All patients (mean age, 50; 60% men) had severe MR, defined as an effective regurgitant orifice area ≥0.4 cm².

The rate of repair (vs. replacement) in the early-surgery group was 94%, compared with 82% in the 26% of conventional-treatment patient…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)