Table 4. Management of residual MR: correct or neglect?
| Mechanism | Type | Inotropes effect | 3D color | Decision |
|---|---|---|---|---|
| Transient and/or dynamic MR | ||||
| Severe LV dysfunction with reduced closing force | I or IIIb | Positive | NA | Neglect: LV support (on bypass) |
| SAM with hypovolemia | NA | Negative | NA | Neglect: filling and stop inotropes |
| Permanent MR | ||||
| Irregularities of leaflet coaptation with trivial or mild central jet (≤1/4) | I | NA | +++ | Neglect |
| Leaflet jet in suture lines or closed to the ring | I | NA | +++ | Correct |
| Leaflet jet at indentation | I | NA | +++ | Correct |
| Residual prolapse or excess traction of Goretex | II or IIIa | NA | ++ | Correct |
| SAM with excess of post-leaflet and/or too small ring | NA | NA | + | Correct |
| Too large ring with central jet or ring dehiscence with periannular jet | I | NA | +++ | Correct |
3D, three-dimensional; LV, left ventricular; MR, mitral regurgitation; NA, not available; SAM, systolic anterior motion.