Prognosis

Some information concerning the prognosis in mitral regurgitation is given below:

• mild regurgitation:
  • prognosis is good
  • risk of infective endocarditis and rarely, chordal rupture in redundant prolapsed cusps
  • regurgitation tends to increase with age
    
    
• severe regurgitation:
  • initially, well tolerated as there is little resistance to left ventricular outflow
  • with time left ventricular failure develops
  • contractility may appear good on echo due to the diminished afterload
  • if surgical repair is left too late, abolition of mitral regurgitation results in a sudden increase in afterload which may not be tolerated by a poor left ventricle
    
    
• ischaemic regurgitation:
  • in the longterm the prognosis is of the underlying coronary disease
    
    
• results from surgery:
  
  
• mortality:
  • valve replacement 6%
  • valve repair 2%
  • increased in patients with left ventricular failure
    
    
• paraprosthetic leak:
  • about 2%
  • higher in prolapsing valves
    
    
• residual mitral regurgitation:
  • mitral valve repair 5%
  • reoperation rate in mitral valve repair of about 2%