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Review Article

Timing of Surgery for Asymptomatic Primary Mitral Regurgitation: Possible Value of Early, Serial Measurements of Left Ventricular Sphericity

Author(s): Alfred Stanley and Constantine Athanasuleas*

Volume 20, Issue 2, 2024

Published on: 13 February, 2024

Article ID: e130224226941 Pages: 9

DOI: 10.2174/011573403X277223240206062319

Price: $65

Abstract

Asymptomatic primary mitral regurgitation due to myxomatous degeneration of the mitral valve leaflets may remain so for long periods, even as left ventricular function progresses to a decompensated stage. During the early compensated stage, the ventricle’s initial response to the volume overload is an asymmetric increase in the diastolic short axis dimension, accomplished by a diastolic shift of the interventricular septum into the right ventricular cavity, creating a more spherical left ventricular diastolic shape, increasing diastolic filling and stroke volume. Early valve repair is recommended to reduce postoperative left ventricular dysfunction. Early serial measurements of left ventricular sphericity index [LV-Si]. during the compensated stage of mitral regurgitation might identify subtle changes in left ventricular shape and assist in determining the optimal earliest timing for surgical intervention.

Keywords: primary mitral regurgitation, left ventricular sphericity, timing of mitral valve repair, left ventricular shape, myxomatous degeneration, diastolic filling.

Graphical Abstract

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