Echocardiographic assessment of anatomic lesions predicts surgical strategy in mitral regurgitation.

Objective --In the present study, we evaluate our ability to predict surgical procedure repair or replacement using preoperative echocardiography. Design --The reports from transthoracic echocardiographic examinations of 298 patients were analyzed and the gross anatomic lesions and the mechanisms involved were classified into one of three main groups ( functional with normal valves, organic degenerated with hypermobile valve or organic degenerated without hypermobility). Results --It was possible to assess the likelihood of repair in 226 patients (76%). The criteria used were institution based and reflect the surgical procedures during the study period (1995-1999). The proportion of patients undergoing repair was 58%. In patients with a high likelihood, repair was performed in 86%. The corresponding figures in the intermediate- and low-likelihood groups were 63 and 23%, respectively. Hypermobility in the posterior leaflet and functional mitral regurgitation led to repair in the majority of patients, while...