Are patients with mitral regurgitation being referred too late for surgery?
MA Borger, T Walther, FW Mohr In the current issue of The Canadian Journal of Cardiology, Toledano et al (pages 209-214) report an important study on cardiologists’ thresholds for surgical referral in patients with mitral regurgitation (MR). The authors mailed a self-administered questionnaire containing seven different clinical scenarios to practising adult cardiologists in Canada. They observed relatively poor compliance with published clinical guidelines, as well as an inverse correlation between compliance and number of years in practice. The current study is particularly timely, given the recent publication of the updated American College of Cardiology and American Heart Association (ACC/AHA) guidelines for the management of patients with valvular heart disease (1). However, Toledano et al used the previously published guidelines (2) to determine the correct recommendations for referral of patients with MR.
