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Figure 5. Indications for Surgery for MR (2017)
Mitral
Regurgitation
MV Surgery
a
(Class IIb)
Primary MR
Symptomatic
(stage D)
MV Surgery
a
(Class I)
a
MV repair is preferred over MV replacement (MVR) when possible.
Severe MR
Vena contracta ≥0.7 cm
RVol ≥60 mL
RF ≥50%
ERO ≥0.4 cm
2
LV dilation
Progressive MR
(stage B)
Vena contracta <0.7 cm
RVol <60 mL
RF <50%
ERO <0.4 cm
2
Asymptomatic
(stage C)
LVEF >30%
YES NO
LVEF 30%–≤60% or
LVESD ≥40 mm
(stage C2)
LVEF >60%
and LVESD
≥40 mm
(stage C1)
New-onset
AF or PASP
>50 mm Hg
(stage C1)
Progressive
increase in LVESD
or decrease in EF
Likelihood of
successful repair
>95% and expected
mortality <1%
YES NO
MV Surgery
(Class IIa)
MV Repair
(Class IIa)
Periodic Monitoring
Mitral Regurgitation
