Prognosis
There is a 1% per-year risk of reoperation after mitral valve repair or replacement. The risk of mortality is lower with mitral valve repair than with replacement; one study found an overall risk of mortality of <1% for patients with primary mitral regurgitation (MR) who underwent mitral valve repair.[29]
Patients with chronic severe secondary MR who are treated with transcatheter edge-to-edge repair of the mitral valve have a lower all-cause mortality at 5 years of follow-up than patients who are treated with medical therapy alone.[30]
MR may remain asymptomatic for many years. Progression of mitral valve disease is variable and depends on progression of lesions or mitral annulus size. Severe MR also has a variable prognosis, but most experts agree that left ventricular dysfunction will occur within 6 to 10 years. For flail posterior mitral leaflet, one longitudinal study found that at 10 years, 90% of the patients had died or required mitral valve operation.[31]
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