The treatment of this condition can be considered in terms of medical and surgical managements, and in terms of treatment of the acute and chronic disease.
Primary mitral regurgitation
- offer surgical mitral valve repair (by median sternotomy or minimally invasive surgery) to adults with severe* primary mitral regurgitation and an indication for repair, if surgery is suitable
- offer surgical mitral valve replacement (by median sternotomy or minimally invasive surgery) to adults with severe* primary mitral regurgitation and an indication for surgery, if the valve is not suitable for repair and surgery is suitable
- consider transcatheter edge-to-edge repair, if suitable, for adults with severe* primary mitral regurgitation and symptoms, if surgery is unsuitable
Secondary mitral regurgitation
- consider surgical mitral valve repair (by median sternotomy or minimally invasive surgery) for adults with severe* secondary mitral regurgitation who are having cardiac surgery for another indication, if surgery is suitable
- consider surgical mitral valve replacement (by median sternotomy or minimally invasive surgery) for adults with severe* secondary mitral regurgitation who are having cardiac surgery for another indication, if the valve is not suitable for repair and surgery is suitable
- offer medical management to adults with heart failure and severe* secondary mitral regurgitation, if surgery is unsuitable
- consider transcatheter mitral edge-to-edge repair for adults with heart failure and severe* secondary mitral regurgitation, if surgery is unsuitable and they remain symptomatic on medical management
* severity of valve disease is defined in line with the British Society of Echocardiography guidelines on the British Heart Foundation's website
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