| Mitral valve repair is the recommended surgical technique when the results are expected to be durable.
293,294,295,296
|
I |
B |
| Surgery is recommended in symptomatic patients who are operable and not high risk.
293,294,295,296
|
I |
B |
| Surgery is recommended in asymptomatic patients with LV dysfunction (LVESD ≥40 mm and/or LVEF ≤60%).
277,286,292
|
I |
B |
| Surgery should be considered in asymptomatic patients with preserved LV function (LVESD <40 mm and LVEF >60%) and AF secondary to mitral regurgitation or pulmonary hypertensionc (SPAP at rest >50 mmHg).
285,289
|
IIa |
B |
| Surgical mitral valve repair should be considered in low-risk asymptomatic patients with LVEF >60%, LVESD <40 mmd and significant LA dilatation (volume index ≥60 mL/m2 or diameter ≥55 mm) when performed in a Heart Valve Centre and a durable repair is likely.
285,288
|
IIa |
B |
| TEER may be considered in symptomatic patients who fulfil the echocardiographic criteria of eligibility, are judged inoperable or at high surgical risk by the Heart Team and for whom the procedure is not considered futile.
299,300,301,302
|
IIb |
B |
| AF: atrial fibrillation; LA: left atrium/left atrial; LV: left ventricle/left ventricular; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic diameter; SPAP: systolic pulmonary arterial pressure; TEER: transcatheter edge-to-edge repair. aClass of recommendations. bLevel of evidence. cIf an elevated SPAP is the only indication for surgery, the value should be confirmed by invasive measurement. dCut-offs refer to average-size adults and may require adaptations in patients with unusually small or large stature. |
