Functional mitral valve regurgitation: repair or replacement?

Hugh D Wolfenden and Greg Cranney
Med J Aust 2016; 205 (10): . || doi: 10.5694/mja16.00553
Published online: 21 November 2016

Long term outcomes primarily depend on left ventricular function

Primary mitral valve disease involves damage to leaflet or chordal tissue,1 whereas functional (or secondary) mitral regurgitation (MR) typically involves a combination of mitral annular dilatation and leaflet restriction caused by ventricular dysfunction in patients with normal leaflets and chordae. Assessing the severity of regurgitation in secondary MR is more difficult than in primary MR, as the regurgitant orifice area is often underestimated by echocardiography because of its crescent shape during systole. Left ventricular stroke volume is usually reduced in secondary MR, so that lesser degrees of regurgitant volume are more significant.

  • Hugh D Wolfenden1,2
  • Greg Cranney1

  • 1 Prince of Wales Hospital, Sydney, NSW
  • 2 Liverpool Hospital, Sydney, NSW

Competing interests:

No relevant disclosures.


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