II: Localized prolapse (P2 and/or A2)
Aetiology
Degenerative
Calcification
No/Localized
Mitral annulus dilatation
Mild/Moderate
Probability of repair
Feasible
I or IIIb
Aetiology
Ischaemic/Functional
Calcification
No
Mitral annulus dilatation
Moderate
Probability of repair
Feasible
II: Extensive prolapse (≥3 scallops, posterior commissure)
Aetiology
Barlow
Calcification
Localized (annulus)
Mitral annulus dilatation
Moderate
Probability of repair
Difficult
IIIa but pliable anterior leaflet
Aetiology
Rheumatic
Calcification
Localized
Mitral annulus dilatation
Moderate
Probability of repair
Difficult
II: Extensive prolapse (≥3 scallops, anterior commissure)
Aetiology
Severe Barlow
Calcification
Extensive (annulus + leaflets)
Mitral annulus dilatation
Severe
Probability of repair
Unlikely
II: Prolapse but destructive lesions
Aetiology
Endocarditis
Calcification
No
Mitral annulus dilatation
No/Mild
Probability of repair
Unlikely
IIIa but stiff anterior leaflet
Aetiology
Rheumatic
Calcification
Extensive (annulus + leaflets)
Mitral annulus dilatation
Moderate/Severe
Probability of repair
Unlikely
IIIb but severe valvular deformation
Aetiology
Ischaemic/Functional
Calcification
No
Mitral annulus dilatation
No or Severe
Probability of repair
Unlikely