Asymptomatic mitral regurgitation—wait or operate?

Goldstone et al. should be congratulated for presenting the first meta-analysis to assess the differences in all-cause mortality between watchful waiting versus early surgery for asymptomatic patients with severe degenerative mitral regurgitation (1). The topic is controversial, and the article is timely in the context of recent changes to the American College of Cardiology/American Heart Association Guidelines (2).