Surgical Approach to Mitral Regurgitation in Chronic Heart Failure: When Is It an Option?
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- Crestanello, J.A. Curr Heart Fail Rep (2012) 9: 40. doi:10.1007/s11897-011-0080-6
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Functional mitral regurgitation (MR) is common in patients with chronic heart failure and adversely affects survival and quality of life. Surgery is effective in improving symptoms and reverse remodeling of the ventricle. However, its effect on survival is unclear. Indications for surgery are challenging given the elevated surgical risk of these patients, lack of prospective randomized data, and uncertain long-term results in the historical series. A systematic approach to functional mitral regurgitation that addresses both the mitral insufficiency and the ventricular remodeling with careful patient selection can achieve reliable, reproducible, and lasting results. This article reviews the surgical procedures to treat functional mitral regurgitation and presents an algorithm for their application in patients with congestive heart failure.