Table of Contents
ISRN Cardiology
Volume 2011 (2011), Article ID 858714, 6 pages
http://dx.doi.org/10.5402/2011/858714
Review Article

Management-Oriented Classification of Mitral Valve Regurgitation

1Department of Cardiac Surgery, Benghazi Medical Center, Benghazi, Libya
2Department of Cardiology, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia

Received 15 February 2011; Accepted 28 March 2011

Academic Editors: G. Iaccarino, B. Liang, and B. Strasberg

Copyright © 2011 Reida El Oakley and Aijaz Shah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mitral regurgitation (MR) has previously been classified into rheumatic, primary, and secondary MR according to the underlying disease process. Carpentier's/Duran functional classifications are apt in describing the mechanism(s) of MR. Modern management of MR, however, depends primarily on the severity of MR, status of the left ventricular function, and the presence or absence of symptoms, hence the need for a management-oriented classification of MR. In this paper we describe a classification of MR into 4 phases according to LV function: phase I = MR with normal left ventricle, phase II = MR with normal ejection fraction (EF) and indirect signs of LV dysfunction such as pulmonary hypertension and/or recent onset atrial fibrillation, phase III = EF ≥ 30%–< 50% and/or mild to moderate LV dilatation (ESID 40–54 mm), and phase IV = EF < 30% and/or severe LV dilatation (ESDID ≥ 55 mm). Each phase is further subdivided into three stages: stage “A” with an effective regurgitant orifice (ERO) < 20 mm, stage “B” with an ERO = 20–39 mm, and stage “C” with an ERO ≥ 40 mm. Evidence-based indications and outcome of intervention for MR will also be discussed.