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Learning Objective #1: discuss the prevalence, diagnosis and treatment for mitral valve disease.

Learning Objective #2: identify the recommendations for care in mitral valve disease from the 2006 ACC/AHA Guidelines for Treatment and Evaluation of Valvular Disease.

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The mitral valve is a complex anatomical structure with mitral valve insufficiency (MVI) representing the second most common type of valve abnormality. The natural history of MVI has evolved in the past years with significant reduction in the incidence of rheumatic fever, longer life expectancy, along with increased recognition of the disorder. MVI continues to constitute a major health problem which will increase with the aging population. Newly released, 2006 American College of Cardiologists and American Heart Association (ACC/AHA) Guidelines for the Treatment of Valvular Disorders will assist medical professionals in gaining scientific background for practice application in changing treatment strategies. Evaluation, management and risk stratification of both asymptomatic and symptomatic patients will be discussed. MVI currently has multiple etiologies yet the most common, degenerative, is also the most successfully repaired. Why repair is becoming the gold standard whenever possible versus mechanical or tissue valve prostheses will be explored. Beyond the pathophysiology of the underlying disease, this session will cover the timing of surgery based on these new guidelines which advocate surgery, even in an asymptomatic patient. Case presentations incorporating diagnosis, diagnostic modalities, guideline recommendations along with operative techniques utilized will assist with an understanding of the implementation of evidence based practice in the care of mitral valve disease.