LAUSR

We summarize the current concepts and methods for diagnosis and management of primary mitral regurgitation due to leaflet prolapse or flail. Current practice guidelines emphasize accurate diagnosis of chronic primary severe MR, differentiating between symptomatic and asymptomatic states, and assessing both hemodynamic and functional impact, thereby ensuring timely surgical or transcatheter intervention for those who stand to benefit from it. No effective medical therapy for chronic severe mitral regurgitation has been found to date. Surgical repair has significant advantages over valve replacement in primary MR patients with favorable anatomy. Transcatheter interventions may be an option in selected patients who are at prohibitive surgical risk. Successful management of chronic severe primary MR relies on accurate diagnosis and careful timing of intervention. Care should be individualized and rely on input from a heart valve team that includes expert imagers, surgeons, and interventional cardiologists.