Properly Downsized Annuloplasty for Functional Mitral Regurgitation: Unbeaten in the Right Patient

Abstract

Treatment of functional mitral regurgitation (FMR) has 2 objectives: restoring mitral valve competence and initiating sustained reverse remodeling of the left ventricle. The use of surgical correction of FMR by means of mitral valve repair, aiming at both goals, has declined in recent years, and current guidelines have only a class IIB recommendation for this procedure in patients without an indication for revascularization. This reduced popularity is mainly the result of poor outcomes in terms of mitral regurgitation (MR) recurrence in the Cardiothoracic Surgery Network Trials, showing “recurrent” MR in 59% of patients 2 years after surgery.