Table 1.

Clinical stages of ischemic mitral regurgitation and surgical procedures

	Stage 1	Stage 2	Stage 3
Severity of MV tethering and LV remodeling
MV tethering	Not extensive (CD <10 mm and IPMD <30 mm)	Extensive (CD ≥10 mm or IPMD ≥30 mm)	Extensive (CD ≥10 mm or IPMD ≥30 mm)+
LV remodeling	Small LV (LVDd <65 mm)	Small LV (LVDd <65 mm) or large LV (LVDd ≥65 mm) with a small scar or no scar	Large LV (LVDd ≥65 mm) with a large scar
Surgical procedures
Valvular	Annuloplasty (downsized)	Annuloplasty (true-sized)	Annuloplasty (true-sized)
Subvalvular	None	PMA (transvalvular or transventricular)	PMA (transventricular)
Ventricular	None	None	Left ventriculoplasty

CD: coaptation distance; IPMD: interpapillary muscle distance; LV: left ventricle; LVDd: LV end-diastolic diameter; MV: mitral valve; PMA: papillary muscle approximation