The Timing of Surgery for Severe Mitral Regurgitation

In this issue of the Journal, Ling et al.1 present a retrospective study of long-term clinical outcomes in a large group of patients with mitral regurgitation diagnosed at the Mayo Clinic. Because the study included only patients with a diagnosis of partial flail mitral leaflet, echocardiography could be used to document severe regurgitation in most patients (in earlier reports, the degree of mitral regurgitation was often uncertain); a valve-repair procedure was feasible in two thirds of the patients treated surgically. Although 71 percent of the 229 patients were in New York Heart Association (NYHA) functional class I or II when . . .