Current Heart Failure Reports

, Volume 9, Issue 1, pp 40–50 | Cite as

Surgical Approach to Mitral Regurgitation in Chronic Heart Failure: When Is It an Option?

  • Juan A. Crestanello
Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (AK Hasan, Section Editor)


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.


Mitral regurgitation Ischemic cardiomyopathy Nonischemic cardiomyopathy Congestive heart failure Mitral valve Mitral valve repair Mitral valve replacement Ischemic mitral regurgitation Surgery Nonpharmacologic therapy 



Dr. Crestanello has received research grants from Edwards LifeSciences and Medtronic.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Cardiac SurgeryThe Ohio State University Medical CenterColumbusUSA

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