[Surgical and Interventional Therapy of Mitral Valve Regurgitation]

Depending from the etiology of mitral valve pathology and surgical risk, mitral valve surgery is the therapy of choice for most degenerative mitral valve diseases. In isolated secondary mitral valve regurgitation, the indication for interventional or conservative therapy becomes more important. In severe left ventricular dysfunction heart transplantation has to be taken into consideration. If relevant coronary artery disease is present and bypass surgery is indicated, mitral valve surgery is mandatory in severe regurgitation and is subject to a benefit-risk evaluation in moderate regurgitation. Decision pathways take multiple aspects into consideration (fig. 4) like comorbidities and physical status of the patient as well as anatomy of the mitral valve and pathology of regurgitation. The choice of they should found after inspection of the patient by a multidisciplinary team consisting of a cardiologist, a cardiac surgeon, an echocardiographer and a cardiac anesthesiologist.