[Chronic organic mitral insufficiency].

Chronic organic mitral regurgitation (MR) has a good functional tolerance but left ventricular dysfunction may precede symptoms' onset. Doppler echocardiography is the key exam: it confirms the diagnosis, establishes the mechanism and etiology and evaluates the severity and the impact on the cardiac cavities and pulmonary pressures. Surgery is the curative treatment. Two types of corrections will be proposed: valve repair or replacement by prosthesis. Surgery is indicated in symptomatic patients presenting severe organic mitral valve insufficiency, as well as in asymptomatic patients presenting signs of left ventricular failure or supraventricular rhythm disorders, such as continuous arrhythmia. Earlier indications in asymptomatic patients can be debated in highly specialized centers provided that chances of low-risk valve repair are high.