Is surgery necessary for mitral valve prolapse?

Mitral valve prolapse is an abnormal condition, which is also relatively common. The human body in this condition often shows many abnormal manifestations, and the incidence rate in men is much higher than that in women. This disease also has certain clinical manifestations, and there are many treatment methods, including surgical treatment. So, is surgery necessary for mitral valve prolapse?

Mitral valve prolapse (MVP) has several names, including systolic click syndrome, viscous mitral valve, and flabby valve syndrome. It is a common but variable clinical syndrome. It is a structural abnormality caused by pathological changes in one or more of the mitral valve apparatus, leaflets, chordae tendineae, papillary muscles, and annulus due to a variety of pathological mechanisms. It is considered to be the most prevalent valvular heart disease, affecting approximately 3-5% of the population, with a male to female ratio of approximately 2:1.

In 1963, Barlow et al. confirmed that it has the characteristics of diastolic click and late systolic murmur on cardiac auscultation, often accompanied by mitral valve prolapse and often with insufficiency.

Surgical treatment 1. Asymptomatic, no arrhythmia on routine electrocardiogram, normal ST segment, and no obvious mitral regurgitation have a good prognosis. In this case, follow-up is required every 3-5 years, and the follow-up content includes two-dimensional ultrasound, Doppler ultrasound, etc.

2. If there is a long systolic murmur, it may indicate the progression of mitral regurgitation, and the follow-up frequency should be increased, with a follow-up period of approximately 12 months;

3. Patients with mitral valve prolapse and severe mitral valve regurgitation require surgical treatment;

4. Prevention of endocarditis: for patients with typical systolic murmur and typical mitral valve prolapse with regurgitation shown by ultrasound;

5. Patients with palpitations, headaches, dizziness, syncope, or ventricular arrhythmias and prolonged QT intervals on routine electrocardiograms or exercise electrocardiograms require electrocardiographic monitoring for at least 24 hours;

6. Patients with mitral valve prolapse and heart failure caused by mitral valve regurgitation should be treated the same as in 3.

7. If there is mitral valve prolapse, accompanied by angina pectoris during exercise or myocardial ischemia changes on the electrocardiogram, or abnormal myocardial radionuclide displays, coronary angiography is required to identify coronary artery abnormalities.

Despite much discussion about the complications of mitral valve prolapse syndrome, we should not forget that, overall, it is a benign condition that remains asymptomatic in the vast majority of patients throughout their lifespan and requires observation and follow-up every few years.