Timing of mitral valve surgery

itral valve surgery has changed considerably in the past decades and is now indicated mostly for pure or predominant mitral regurgitation. This is the result of the regression of rheumatic disease, of the efficacy of mitral balloon valvuloplasty for mitral stenosis, and of the aging of the population with increasing degenerative or ischaemic disease causing mitral regurgitation. Mitral regurgitation can be "organic" (that is, caused by intrinsic mitral disease such as rheumatic disease, ruptured chord, perforation of leaflet) or be "functional" (that is, where a normal valve regurgitates because of ventricular dysfunction).