title: Degenerative mitral valve regurgitation: understanding basic concepts and new developments.
abstract: Chronic degenerative mitral regurgitation is the most common valvular disease in the United States. The objective of this review article is to impart a balanced understanding of the basic concepts and new developments in assessment and management of patients with severe degenerative mitral regurgitation. Etiologic, epidemiologic, pathologic, and physiopathologic concepts are discussed, as well as the importance of surgical mitral valve repair as the current gold standard treatment. Research efforts in "decoding" the natural history and prognosis of patients with severe degenerative mitral regurgitation have produced important insights into the surgical timing of patients with asymptomatic mitral regurgitation, and the concept of early restorative surgery has emerged.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. michelena.hector@mayo.edu
authors.forename: Hector I
authors.initials: HI
authors.lastname: Michelena
authors.forename: Yan
authors.initials: Y
authors.lastname: Topilsky
authors.forename: Rakesh
authors.initials: R
authors.lastname: Suri
authors.forename: Maurice
authors.initials: M
authors.lastname: Enriquez-Sarano
mesh_terms: D018450:Disease Progression; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors; D057832:Watchful Waiting