[Prognosis of organic mitral regurgitation and implications for surgical indications]

The term organic Mitral Regurgitation (MR) relates to MR secondary to anatomic alteration of the valvular or subvalvular mitral apparatus and refers to rheumatic MR and degenerative MR, i.e. mitral valve prolapse, which has become in the past 20 years the 1st cause of severe MR leading to surgery in western countries. Recent publications on the prognosis of patients with MR secondary to flail leaflet, showed that these patients incur excess mortality rates as compared to expected and that ten years after diagnosis, 90% of those will either be dead or operated on for severe symptoms. On the other hand, analysis of postoperative prognosis showed that the best results of surgical correction were observed in asymptomatic patients with normal pre-operative left ventricular function. The prognosis of these patients was then similar to that expected if a valvular repair was performed, making of mitral repair the hinge point of early surgical strategies.