Inclusion center (per December 2018)
- Amsterdam UMC – 1 inclusion
- Amphia Ziekenhuis Breda – 31 inclusions
- Medisch Spectrum Twente – 10 inclusions
- UMC Utrecht – 56 inclusions
- Maastricht UMC – 3 inclusions
- 18-75 years.
- Asymptomatic patients ― Asymptomatic is defined as absence of subjective limitations of exercise capacity or complaints expressed by the patient and confirmed by the treating cardiologist.
- Severe organic mitral valve regurgitation ― Severe organic mitral valve regurgitation is defined as non-ischemic mitral valve regurgitation with an organic cause (intrinsic valve lesion) as determined by echocardiographic core-lab reading based on the criteria for definition of severe MR as issued by the ESC guidelines on the management of Valvular Heart Disease (version 2017). For practical reasons, referring cardiologists can use an ESC guidelines based index that was validated in our core-lab (Jansen et al, Practical echocardiographic semi-quantitative scoring system to determine severity of mitral regurgitation).
- Preserved left ventricular function ― Preserved left ventricular function is defined as left ventricular ejection fraction >60% and left ventricular end-systolic dimension ≤45 mm by the ESC guidelines on the management of Valvular Heart Disease (version 2017).
- The likelihood of MV repair should be more than 90% determined by the local heart team with a cardiologist and cardiothoracic surgeon.
- Pulmonary hypertension (>50mmHg)
- Atrial fibrillation
- High surgical risk/inoperable patient
- Left ventricular end systolic dimension > 40mm and one of the following: flail leaflet or LA volume >60 ml/m2 BSA at sinus rhythm
- eGFR < 30 mL/min