Triggers for surgical referral in degenerative mitral valve regurgitation

Degenerative mitral valve disease is the most common etiology of mitral regurgitation in developed countries. Degenerative mitral valve disease should be distinguished from other valvular disease because most of the lesions caused by degenerative changes are amenable to valve repair as opposed to replacement, and successful durable repair with optimal timing can maintain the patient's normal life expectancy. Despite dramatic surgical progress in degenerative mitral valve repair over the past few decades and detailing of surgical indications in established practice guidelines, prevailing data suggest a significant number of patients are still not referred for surgery in a timely fashion or are even denied for surgery for inappropriate reasons. This article reviews the current surgical triggers which all practicing cardiovascular specialists should be familiar with and which should prompt immediate surgical referral.