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| <span style="font-size:85%">'''Abbreviations:''' '''LVEF:''' left ventricular ejection fraction; '''LVESD:''' left ventricular end systolic diameter; '''MR:''' mitral regurgitation; '''PASP:''' Pulmonary artery systolic pressure </span> | | <span style="font-size:85%">'''Abbreviations:''' </span> |
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| | <div style="float: left; text-align: left; width:15em "> |
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| {{Family tree/start}} | | {{Family tree/start}} |
| {{ Family tree | | | | | | | | | | | | | A01 | | | | | | | A01= '''Primary MR'''}} | | {{ Family tree | | | | | A01 | | | | | A01= Secondary MR and patient is receiving medical therapy}} |
| {{ Family tree | | | | | | | | | | | | | |!| | | | | | | | }} | | {{ Family tree | | | | | |!| | | | | | }} |
| {{ Family tree | | | | | | | | | | | | | B01 | | | | | | | B01= What is the severity of MR? }} | | {{ Family tree | | | | | A02 | | | | A02= What is the severity of MR?}} |
| {{ Family tree | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| |}} | | {{ Family tree | |,|-|-|-|+|-|-|-|.| | }} |
| {{ Family tree | | | | | | | C01 | | | | | | | | | | C02 | C01= '''Severe MR''' <br><div style="float: left; text-align: left; width:15em "> | | {{ Family tree | B01 | | B02 | | B03 | | B01= Symptomatic (NYHA class III-IV) severe MR <br> ''(Stage D)'' <br> Asymptomatic severe MR <br> ''(Stage C)'' <br> Progressive MR <br> ''(Stage B)''}} |
| ❑ Severe MVP with loss of coaptation <br>
| | {{ Family tree | |!| | | |!| | | |!| | | }} |
| ❑ RHD with loss of central coaptation<br>
| | {{ Family tree | C01 | | C02 | | C03 | | C01= Mitral valve surgery (Class IIb)| C02= Periodic monitoring| C03= Periodic monitoring}} |
| ❑ Left ventricular dilation <br>
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| ❑ Regurgitation fraction ≥ 50% <br>
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| ❑ Regurgitation volume ≥ 60ml <br>
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| ❑ Effective regurgitation orifice ≥ 0.4cm² <br>
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| ❑ Vena contracta ≥ 0.7cm </div>| C02= '''Progressive MR'''<br> ''(Stage B)'' <br><div style="float: left; text-align: left; width:15em ">
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| ❑ Severe MVP with normal coaptation <br>
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| ❑ RHD with normal coaptation <br>
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| ❑ No Left ventricular dilation <br>
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| ❑ Regurgitation fraction < 50% <br>
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| ❑ Regurgitation volume < 60ml <br>
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| ❑ Effective regurgitation orifice < 0.4cm² <br>
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| ❑ Vena contracta < 0.7cm </div>}}
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| {{ Family tree | | | | | | | |!| | | | | | | | | | | |!|}}
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| {{ Family tree | | | | | | | D00 | | | | | | | | | | |!| D00= Is the patient symptomatic?}}
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| {{ Family tree | | | |,|-|-|-|^|-|-|-|.| | | | | | | |!| }}
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| {{ Family tree | | | D01 | | | | | | D02 | | | | | | |!| D01= Yes <br> ''(Stage D)''| D02= No <br> ''(Stage C)''}}
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| {{ Family tree | | | |!| | | |,|-|-|-|+|-|-|-|.| | | |!| }}
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| {{ Family tree | | | E01 | | E02 | | E03 | | E04 | | |!| E01= Is the [[LVEF]]>30%?| E02= [[LVEF]] 30-60% <br> OR <br> LVESD≥40 mm <br> ''(Stage C2)''| E03= [[LVEF]]>60% <br> AND <br> LVESD<40 mm <br> ''(Stage C1)''| E04= New onset [[atrial fibrillation]]<br> OR <br> PASP>50 mmHg <br> ''(Stage C1)''}}
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| {{ Family tree | |,|-|^|-|.| |!| | | | |!| |!| | | | |!| }}
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| {{ Family tree | |!| | | |!| |!| | | | | F00 | | | | |!| F00= <div style="float: left; text-align: left; width:15em ">Is the likelihood of success for the valve repair >95% and the expected mortality <1%? </div>}} | |
| {{ Family tree | |!| | | |!| |!| | |,|-|-|^|-|.| | | |!| }}
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| {{ Family tree | F01 | | F02 |!| | F03 | | | F04 | | |!| F01= No| F02= Yes| F03= Yes| F04= No}} | |
| {{ Family tree | |!| | | | |!|!| | |!| | | | |!| | | |!| }}
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| {{ Family tree | G01 | | | G02 | | G03 | | | G04 | | G05 | G01= [[Mitral valve surgery]] (Class IIb)| G02= [[Mitral valve surgery]] (Class I)| G03= [[Mitral valve repair]] (Class IIa)|G04= Periodic monitoring| G05= Periodic monitoring}}
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| {{ Family tree/end}} | | {{ Family tree/end}} |