A 59 year old man with severe myxomatous mitral regurgitation is asymptomatic, with a left ventricular ejection fraction of 45% and an endsystolic diameter index of 2.9 cm/m2. The most appropriate treatment is:
Answer is A (Mitral valve repair or replacement) "Surgical treatment of severe MR should be considered even in asymptomatic patients or those with mild symptoms whose LV dysfunction is progressive with LV ejection fraction declining below 60%"
Mitral valve repair or replacement
No treatment
ACE inhibitor therapy
Digoxin and diuretic therapy