Medical and surgical management of mitral regurgitation

Management include medical and surgical modalities

Medical management include

• Prophylaxis of IEC and RF.
• Afterload reduction is achieved with ACE inhibitors or nifedipin

Symptomatic patient are given

• Diurectics and digoxin in heart failure
• In patients with atrial fibrillation
• Drugs to reduce the heart rate is given.
• Anti coagulation and cardioversion is given if required
• Anticoagulants are given in patients with atrial fibrillation and embolic episodes.

Surgical options include 

Mitral valvuloplasty 

MitralValve replacement

Indications for MV repair (Valvuloplasty or annuloplasty) are the following

1.Mitral valve prolapse
2.Mitral valve annular calcification
3.Chordal rupture
4.Papillary muscle rupture

MV repair helps to maintain the annulo cardo papillary muscle continuity.

What are the indication for mitral valve replacement

Class III, IV symptoms

Severe  MR with following

1.Left ventricular ejection fraction <60

2.LV and systolic diameter >50mm by echo.