ABSTRACT
Introduction For patients with severe mitral regurgitation, surgical repair or replacement has long been considered the standard of care to improve heart failure and functional status and limit progressive le ventricular dilation and failure. Knowledge about the optimal surgical treatment approach has evolved with the development of new valves and surgical techniques. In general, we have learned that mitral valve repair is preferred over replacement when possible, as this maintains ventricular geometry and mitigates the risks of a prosthetic valve. When necessary, mitral valve replacement is most successful when the subvalvular apparatus is preserved. Treatment of valve disease continues to evolve, and reviewing the lessons of surgical valve treatment is important when considering the benets and potential challenges to another frontier in mitral valve therapies, transcatheter mitral valve implantation (TMVI). is chapter serves to review the evolution of surgical valve care and outline how this experience pertains to TMVI.
