Asymptomatic Severe MR – Dr Robecca T Hahn

2^nd National Heart Valve Summit 2012

1.       Symptomatic MV needs intervention

2.       Asymptomatic, normal EF, normal dimensions needs evaluation

3.       AF, AH may mean surgical intervention

4.       Large central jet > 10 cm means severe MR

5.      Modern management of patients with chronic mitral regurgitation (MR) requires an understanding of multiple factors: These include:

• The pathophysiology and natural history of the disease
• The severity of the valvular lesion
• The development of atrial fibrillation
• The therapeutic potential of chronic vasodilator therapy
• The indications for endocarditis prophylaxis
• The indications for mitral valve repair and mitral valve replacement.

6.     Based upon the 2003 American Society of Echocardiography guidelines(11) , the following findings, in order or priority, are consistent with severe MR

• A vena contracta width ≥7 mm
• A regurgitant orifice area ≥0.40 cm2
• A regurgitant volume ≥60 mL
• A regurgitant fraction ≥50 percent
• A jet area >40 percent of left atrial area, but this is not so reproducible and less often used