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Early MV Repair in Asymptomatic Severe MR — EECC MCQ

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HardValvular Heart DiseaseEarly MV Repair in Asymptomatic Severe MREECC

An asymptomatic patient has severe primary degenerative mitral regurgitation, LVEF 61%, LV end-systolic diameter 39 mm, sinus rhythm and pulmonary artery systolic pressure 38 mmHg. Durable repair is highly likely at a Heart Valve Centre. What most strongly determines whether early surgery is justified?

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Correct answer: E — Base early repair on Heart Team risk and durability assessment

In asymptomatic severe primary MR with preserved ventricular dimensions, intervention is not triggered by severity alone. The Heart Valve Centre should integrate repair probability, operative risk, serial LV change, atrial fibrillation, pulmonary pressure, atrial size, exercise findings and other adverse markers. A durable low-risk repair may justify earlier intervention in selected patients, whereas careful surveillance is appropriate when those conditions are absent. The original item overclaimed that every listed feature independently mandated surgery.

Reference: 2025 ESC/EACTS Guidelines for valvular heart disease. https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/valvular-heart-disease/