Surgical management of mitral regurgitation Review article
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Abstract
Mitral insufficiency is defined as the retrograde blood flow (from the left ventricle to the left atrium) which results from the impaired function of the valve leaflets. The proper function of the mitral valve is related not only to the proper anatomy of the valvular and subvalvular structures but also to their cooperation with the left chambers of the heart. The most common type of chronic mitral regurgitation is rheumatic regurgitation. Mitral disease may be also due to degenerative changes of the mitral apparatus, infective endocarditis or ischemic heart disease. Mitral regurgitation may develop acutely as a result of chordal rupture or infective endocarditis or may may complicate the myocardial infarction. Symptomatic patients with LVEF >35% and ESD <55 mm as well as asymptomatic patients with poor left ventricle function (LVEF ≤60%, ESD >45 mm) are indicated for surgery. There are two surgical strategies on the level of treatment: mitral valve repair or mitral valve replacement. Is has been widely proven that mitral valve sparing operation is more beneficial in comparison to mitral valve replacement. What is the optimal time for mitral valve surgery – the answer to this question seems to be essential. The best results can be expected when we operate patients with left ventricle systolic function maintained.
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