Surgical therapy of mitral regurgitation. When, whom, how?,Chirurgische therapie der mitralinsuffizienz. Wann, wen, wie?

Surgical therapy for mitral valve regurgitation is undergoing significant change. For decades mitral valve replacement was the first choice therapy; now we know that mitral reconstruction has to be performed whenever it is technically possible. Numbers from experienced centers imply that in more than 80% of patients with significant mitral valve disease reconstruction is feasible. Today even asymptomatic patients fulfill the indication for mitral valve surgery once mitral reconstruction can be performed and surgical risk is low. Minimally invasive mitral valve reconstructions have furthermore lowered operative invasiveness and go along with low complication rates and excellent results. Mortality after isolated mitral valve surgery can be as low as 0% in experienced centers. Life expectancy of patients after mitral valve reconstruction is at the level of the average population at the same age if the right time point for the operation is chosen.