The Role of Echocardiography in the Surgical Management of Secondary Mitral Regurgitation

Secondary mitral regurgitation (MR) is more frequent, portends a worse prognosis and its diagnostic and management are more difficult in comparison with primary MR. The mechanism of secondary MR is linked to the left ventricle remodeling, while the valve morphology is normal. Surgical treatment of severe secondary MR consists either in mitral valve replacement or in mitral valve repair. The most commonly used repair technique is represented by undersized mitral annuloplasty. This surgical technique implieslowersurgical risk but associates a higher rate of postoperative MR recurrence, compared to mitral valve replacement. Echocardiography provides geometric parameters related to mitral apparatus deformation, which are able to predict the success or failure of mitral valve repair and thus helps in selecting the best surgical strategy for each patient. In this paper we try to make an inventory of the echocardiographical parameters which proved predictive power for unsuccessful mitral valve repair techniques.