Degenerative Mitral Valve Repair

Degenerative mitral regurgitation (MR) is a rather common pathology. If untreated, severe MR leads to left ventricular failure, pulmonary hypertension, atrial fibrillation and death. Correction of MR can be associated with a life expectancy and a quality of life similar to those of the normal healthy population, when performed appropriately and timely. In many patients, degenerative MR is characterised by an excess of valve tissue with elongated or ruptured chordae (Barlow’s disease) , while in others, the leaflets are thinner and translucent and chordae are very fragile (fibroelastic deficiency). Mitral valve prolapse is the consequence of these anatomical alterations affecting primarily the leaflets and the subvalvular apparatus. American and European guidelines for the treatment of heart valve disease indicate the criteria for appropriate management of patients with degenerative MR. The aim of this editorial is to briefly explore the optimal management of patients affected by degenerative MR.