Twenty-Five–Year Follow-Up of Quantified Mitral Regurgitation

Among asymptomatic patients with mitral regurgitation (MR), how is baseline effective regurgitant orifice area (ERO) associated with long-term survival, and how does survival compare between patients who did vs did not undergo operation? In this cohort study including 449 patients, increasing ERO was associated with progressively worse survival, while mitral valve surgery was associated with survival comparable to or better than that observed at lower ERO values. The survival benefit associated with surgery appeared most evident once ERO exceeded the moderate range. The findings suggest that an integrative approach incorporating multiple echocardiographic parameters, ventricular response, and clinical features may be useful to better characterize MR disease severity and future risk and to inform management decisions.

Corresponding Author: Hartzell V. Schaff, MD, Department of Cardiovascular Surgery, Mayo Clinic, 1216 Second St SW, Rochester, MN 55902 (schaff@mayo.edu).

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