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HardCardiologySevere Mitral Regurgitationus-abimus-usmle-step-2us-usmle-step-3

A 60-year-old man with long-standing hypertension presents with dyspnea on exertion and a high-pitched blowing holosystolic murmur best heard at the apex radiating to the axilla. Echo shows severe degenerative mitral regurgitation with normal LV systolic function and new onset atrial fibrillation. He is minimally symptomatic. What is the recommended management?

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