Mitral valve repair best course of action. For patients with the most common type of mitral valve disease, termed "degenerative" or "myxomatous" mitral valve disease, repair rates are very high and long term durability is excellent. There has been great debate about timing of surgery in patients with asymptomatic mitral valve regurgitation. The traditional surgical approach to a mitral valve repair is a full or partial sternotomy, in which the surgeon cuts through the breastbone at the center of the chest to access the heart. There are minimally invasive (port access) options available pioneered by Hugo Vanerman in Belgium. The minimally invasive approach
Mitral valve prolapse Two- and three-dimensional echocardiography are particularly valuable as they allow visualization of the mitral leaflets relative to the mitral annulus. This allows measurement of the leaflet thickness and their displacement relative to the annulus. Thickening of the mitral leaflets >5 mm and leaflet displacement >2 mm indicates classic mitral valve prolapse. Prolapsed mitral valves are classified into several subtypes, based on leaflet thickness, type of connection to the mitral annulus, and concavity. Subtypes can be described as classic, nonclassic, symmetric, asymmetric, flail, or non-flail. All measurements below refer to adult patients; applying them to children may be misleading. Prolapse occurs