Contemporary Surgical Treatment for Functional Mitral Regurgitation

Abstract

The treatment of functional mitral regurgitation (FMR) has evolved dramatically in recent years and remains dynamic. Generally, the treatment of FMR involves a combination of medication optimization and surgical or transcatheter interventions. The use of transcatheter edge-to-edge repair has been increasing for FMR. This less invasive approach allows for transcatheter mitral valve repair, avoiding open heart surgery. On the other hand, surgical mitral valve repair techniques, such as annuloplasty, still play a crucial role in managing FMR. Simultaneous surgical ablation for atrial fibrillation or left atrial appendage closure can be performed. Surgical interventions also encompass concomitant operations, including addressing commonly coexisting secondary tricuspid valve pathology or performing coronary artery bypass grafting, which is relevant, especially in the case of ischemic mitral regurgitation. The management of FMR involves a multidisciplinary heart team consisting of cardiologists, cardiac surgeons, and other specialists. This collaborative approach aims to tailor treatment strategies to individual patients, considering survival and the quality of life.