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| {{SI}}
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| {{CMG}}
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| '''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S ; [[Lakshmi Gopalakrishnan]], M.B.B.S
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| {{Editor Help}}
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| ==Complications of Mitral Regurgitation==
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| Mitral Regurgitation when mild almost never cause any complications. However, when severe, it may lead to development of:
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| *[[Pulmonary Edema]]
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| *[[Pulmonary Hypertension]]
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| *[[Right Heart Failure]]
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| *[[Atrial Fibrillation]]
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| *[[Thromboembolism]]-[[Stroke]]
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| *[[Endocarditis]]
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| ==Prognosis==
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| *Patients with asymptomatic chronic severe mitral regurgitation have a high likelihood of developing symptoms or LV dysfunction over the course of 6 to 10 years <ref name="pmid8875918">{{cite journal |author=Ling LH, Enriquez-Sarano M, Seward JB, Tajik AJ, Schaff HV, Bailey KR, Frye RL |title=Clinical outcome of mitral regurgitation due to flail leaflet |journal=[[The New England Journal of Medicine]] |volume=335 |issue=19 |pages=1417–23 |year=1996 |month=November |pmid=8875918 |doi=10.1056/NEJM199611073351902 |url=http://dx.doi.org/10.1056/NEJM199611073351902 |accessdate=2011-03-06}}</ref> <ref name="pmid15745978">{{cite journal |author=Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, Detaint D, Capps M, Nkomo V, Scott C, Schaff HV, Tajik AJ |title=Quantitative determinants of the outcome of asymptomatic mitral regurgitation |journal=[[The New England Journal of Medicine]] |volume=352 |issue=9 |pages=875–83 |year=2005 |month=March |pmid=15745978 |doi=10.1056/NEJMoa041451 |url=http://dx.doi.org/10.1056/NEJMoa041451 |accessdate=2011-03-06}}</ref> <ref name="pmid16651470">{{cite journal |author=Rosenhek R, Rader F, Klaar U, Gabriel H, Krejc M, Kalbeck D, Schemper M, Maurer G, Baumgartner H |title=Outcome of watchful waiting in asymptomatic severe mitral regurgitation |journal=[[Circulation]] |volume=113 |issue=18 |pages=2238–44 |year=2006 |month=May |pmid=16651470 |doi=10.1161/CIRCULATIONAHA.105.599175 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=16651470 |accessdate=2011-03-06}}</ref>. However, the incidence of sudden death in asymptomatic patients with normal LV function varies widely among these studies.
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| *Clinical outcome is poor in patients with severe symptomatic mitral regurgitation with eight year survival rate of 33% without surgical intervention. Heart failure being the common cause with sudden death attributing to ventricular arrhythmia.<ref name="pmid1936025">{{cite journal |author=Delahaye JP, Gare JP, Viguier E, Delahaye F, De Gevigney G, Milon H |title=Natural history of severe mitral regurgitation |journal=[[European Heart Journal]] |volume=12 Suppl B |issue= |pages=5–9 |year=1991 |month=July |pmid=1936025 |doi= |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=1936025 |accessdate=2011-03-06}}</ref>
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| *In patients with severe mitral regurgitation due to a flail posterior leaflet, 90% of patients are dead or require MV operation at 10years with the mortality rate in patients with severe mitral regurgitation being 6% to 7% per year. However, the risk of death are predominantly in patients with <60% left ventricular ejection fraction or with NYHA functional class III–IV symptoms <ref name="pmid8875918">{{cite journal |author=Ling LH, Enriquez-Sarano M, Seward JB, Tajik AJ, Schaff HV, Bailey KR, Frye RL |title=Clinical outcome of mitral regurgitation due to flail leaflet |journal=[[The New England Journal of Medicine]] |volume=335 |issue=19 |pages=1417–23 |year=1996 |month=November |pmid=8875918 |doi=10.1056/NEJM199611073351902 |url=http://dx.doi.org/10.1056/NEJM199611073351902 |accessdate=2011-03-06}}</ref> <ref name="pmid9918527">{{cite journal |author=Tribouilloy CM, Enriquez-Sarano M, Schaff HV, Orszulak TA, Bailey KR, Tajik AJ, Frye RL |title=Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications |journal=[[Circulation]] |volume=99 |issue=3 |pages=400–5 |year=1999 |month=January |pmid=9918527 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=9918527 |accessdate=2011-03-06}}</ref>.
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| *Severe symptoms also predict a poor outcome after mitral valve repair or replacement. Postoperative survival rates in patients with NYHA functional class III–IV symptoms at 5 and 10 years are 73±3% and 48±4%, respectively. While in patients with NYHA functional class I/II symptoms before surgery survival rates at 5 and 10 years are 90±2% and 76±5%, respectively<ref name="pmid9918527">{{cite journal |author=Tribouilloy CM, Enriquez-Sarano M, Schaff HV, Orszulak TA, Bailey KR, Tajik AJ, Frye RL |title=Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications |journal=[[Circulation]] |volume=99 |issue=3 |pages=400–5 |year=1999 |month=January |pmid=9918527 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=9918527 |accessdate=2011-03-06}}</ref>.
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| *In a long-term retrospective study <ref name="pmid15745978">{{cite journal |author=Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, Detaint D, Capps M, Nkomo V, Scott C, Schaff HV, Tajik AJ |title=Quantitative determinants of the outcome of asymptomatic mitral regurgitation |journal=[[The New England Journal of Medicine]] |volume=352 |issue=9 |pages=875–83 |year=2005 |month=March |pmid=15745978 |doi=10.1056/NEJMoa041451 |url=http://dx.doi.org/10.1056/NEJMoa041451 |accessdate=2011-03-06}}</ref>, 198 patients with an effective orifice area >40 mm² had a risk of cardiac death at 4% per year during a mean follow-up period of 2.7 years. However, in the another study where 132 patients were followed up prospectively for 5 years, indications for surgery were development of symptoms, LV dysfunction (EF <60%), LV dilatation (LV end-systolic diameter >45 mm), atrial fibrillation, or pulmonary hypertension and there was only 1 cardiac death in an asymptomatic patient, but this patient had refused surgery though it was indicated by development of LV dilation <ref name="pmid16651470">{{cite journal |author=Rosenhek R, Rader F, Klaar U, Gabriel H, Krejc M, Kalbeck D, Schemper M, Maurer G, Baumgartner H |title=Outcome of watchful waiting in asymptomatic severe mitral regurgitation |journal=[[Circulation]] |volume=113 |issue=18 |pages=2238–44 |year=2006 |month=May |pmid=16651470 |doi=10.1161/CIRCULATIONAHA.105.599175 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=16651470 |accessdate=2011-03-06}}</ref>.
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| *In 80% of patients with atrial fibrillation greater than or equal to 3months duration during preoperative period had persistence of atrial fibrillation after surgery <ref name="pmid8302059">{{cite journal |author=Chua YL, Schaff HV, Orszulak TA, Morris JJ |title=Outcome of mitral valve repair in patients with preoperative atrial fibrillation. Should the maze procedure be combined with mitral valvuloplasty? |journal=[[The Journal of Thoracic and Cardiovascular Surgery]] |volume=107 |issue=2 |pages=408–15 |year=1994 |month=February |pmid=8302059 |doi= |url= |accessdate=2011-03-06}}</ref>.
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| ==References==
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| {{reflist|2}}
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| [[Category:cardiology]]
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| {{WH}}
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| {{WS}}
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