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MediumMitraClip) is reasonable in selected patients. Medical therapy alone may be insufficient. Surgery is not always first in secondary MR. Anticoagulation is not a treatment for MR. Ablation treats arrhythmiaACC/AHA Guideline (2020): Valvular Heart Diseasecardiology

A 62-year-old with HFrEF and EF 35% on maximized GDMT has persistent MR due to secondary (functional) MR. Symptoms NYHA III despite euvolemia. Next step?

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