Dr. Suri reported ties to Edwards Lifesciences, Sorin Group, St. Jude Medical, and Abbott. His associates reported ties to Edwards Lifesciences, Valtech, and Abbott Vascular.
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Early surgery vs. watchful waiting for flail mitral leaflets
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Postponing surgery may still be appropriate
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The findings by Dr. Suri and his associates indicate that it may be more beneficial to offer early surgery rather than wait for symptom onset or classic indications for intervention, said Dr. Catherine M. Otto.
"However, if surgical risk is high or if the likelihood of valve repair is low, it remains uncertain whether early surgical intervention is appropriate in the asymptomatic patient with severe mitral regurgitation due to a flail leaflet when LV size and systolic function are normal. Although the majority of these patients will develop clear indications for valve surgery within 2 years, it may be reasonable to postpone the risks of having an intervention and having a prosthetic valve as long as possible," she said.
Catherine M. Otto. M.D., is with the division of cardiology at the University of Washington, Seattle. She reported no financial conflicts of interest. These remarks were taken from her editorial (JAMA 2013;310:587-8) accompanying Dr. Suri’s report.
FROM JAMA