Consensus of the German Cardiac Society and the German Society for Thoracic and Cardiovascular Surgery on treatment of mitral valve insufficiency

Mitral valve regurgitation is one of the most important and frequent valve diseases in the western hemisphere. Primary mitral valve regurgitation is due to pathological alterations of the valve structure itself, whereas secondary mitral valve regurgitation is due to pathology of the left ventricle which ultimately leads to deterioration of mitral valve functioning and mitral regurgitation. The diagnostic pathway requires various cardiovascular examinations. Central diagnostic tool resembles echocardiography which provides besides visual impressions semi quantitative and quantitative parameters. Treatment options in patients with mitral valve regurgitation are based on interdisciplinary discussion between cardiologists and heart surgeons in the heart team. Besides the conservative treatment including medical and device heart failure therapy, surgical and interventional procedures are to be discussed in order to reduce mitral valve regurgitation. The decision making is greatly influenced by the nature of mitral valve regurgitation and by the concomitant comorbidities.