title: Mitral valve repair.
abstract: Mitral regurgitation (MR) is the most common valvular heart disease in the Western world. The MR can be either organic (mainly degenerative in Western countries) or functional (secondary to left ventricular remodeling in the context of ischemic or idiopathic dilated cardiomyopathy). Degenerative and functional MR are completely different disease entities that pose specific decision-making problems and require different management. The natural history of severe degenerative MR is clearly unfavorable. However, timely and effective correction of degenerative MR is associated with a normalization of life expectancy. By contrast, the prognostic impact of the correction of functional MR is still debated and controversial. In this review, we discuss the optimal treatment of both degenerative and functional MR, taking into account current surgical and percutaneous options. In addition, since a clear understanding of the etiology and mechanisms of valvular dysfunction is important to guide the timing and choice of treatment, the role of the heart team and of echo imaging in the management of MR is addressed as well.
authors.affiliation: Department of Heart Surgery, Vita-Salute University of Milan, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pozzoli
authors.affiliation: Department of Heart Surgery, Vita-Salute University of Milan, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: De Bonis
authors.affiliation: Department of Heart Surgery, Vita-Salute University of Milan, Milan, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
keywords: Mitral regurgitation; Mitral valve; Percutaneous intervention; Transesophageal echocardiography