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The American College of Cardiology (ACC) published a set of consensus recommendations for the treatment of mitral regurgitation as evidence is evolving.

"This Expert Consensus Document emphasizes that recognition of mitral regurgitation should prompt an assessment of its etiology, mechanism, and severity, as well as indications for treatment," according to writing committee chair Patrick O'Gara, MD, of Boston's Brigham and Women's Hospital, and colleagues.

"A structured approach to evaluation based on clinical findings, precise echocardiographic imaging, and when necessary, adjunctive testing, can help clarify decision making. Treatment goals include timely intervention by an experienced heart team to prevent left ventricular dysfunction, heart failure, reduced quality of life, and premature death," they wrote in the recommendations published online in the .

Key points in the mitral regurgitation document (part of a series now dubbed Expert Consensus Decision Pathways) were:

• Clinicians should recognize the prognostic, evaluative, and management differences between primary and secondary mitral regurgitation

• Ongoing communication between members of the heart team at the valve treatment center and the referring provider is strongly endorsed
• Transcatheter edge-to-edge repair (with devices like the MitraClip and the Mobius II) is limited to symptomatic patients with primary, severe mitral regurgitation who are poor operative candidates
• Evidence-based medical and device therapy should be optimized in patients with secondary mitral regurgitation before clinicians opt for surgical intervention

O'Gara's group emphasized that their current efforts are not meant to replace the 2014 American Heart Association/ACC Guideline for the Management of Patients with Valvular Heart Disease nor its 2017 focused update.

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