Surgery for degenerative mitral valve disease

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5339 (Published 12 November 2010) Cite this as: BMJ 2010;341:c5339
  1. Norman Briffa, consultant cardiothoracic surgeon
  1. 1Chesterman Wing, Northern General Hospital, Sheffield S5 7AU, UK
  1. norman.briffa{at}sth.nhs.uk

Rates of repair are improving, but there is still wide variation

Mitral valve prolapse is the most common cause of mitral regurgitation requiring surgical correction in Western Europe and the United States.1 This condition is characterised by the accumulation of glycosaminoglycans in leaflet tissue and the appearance of billowing thickened leaflets on echocardiography.2 Although mitral valve prolapse (also called floppy mitral valve or Barlow’s syndrome) occurs in 4-6% of the population, only a small proportion of these people develop severe mitral valve regurgitation requiring intervention. People at risk include those over 50 years and patients with severe valvular regurgitation, atrial fibrillation, and greater thickening of leaflets.2 Without treatment severe mitral regurgitation leads to deterioration of left ventricular function, pulmonary hypertension, and premature death.1

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The aim of surgery is to …

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