Cochran and Verrier developed an algorithm for management decisions in a patient with mitral valve disease. The authors are from the Universities of Wisconsin and Washington (Seattle).
Parameters:
(1) Is the mitral valve repairable?
(2) Does the patient have atrial fibrillation?
(3) Is the patient a good surgical risk, able to withstand a longer operative procedure?
Management options:
(1) mitral valve repair
(2) mechanical prosthetic valve
(3) biologic valve
(4) homograft
Mitral Valve Repair
Atrial Fibrillation
Good Surgical Risk
Management
Yes
Yes
Yes
mitral valve repair
Yes
Yes
No
mechanical valve
Yes
No
Yes
mitral valve repair
Yes
No
No
biologic valve
No
Yes
Yes
mechanical valve
No
Yes
No
biologic valve
No
No
Yes
homograft
No
No
No
biologic valve
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