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876-7.994). Mitral PPM did not adversely affect long-term survival. There may be a tendency of adverse impact on late survival in patients aged ≤70 years. Implanting a safe size rather than larger size prosthesis in mitral position may be an appropriate option in older patients. The timing for surgical treatment in patients with primary organic severe mitral valve regurgitation (MR) and preserved left ventricular ejection fraction (LVEF) systolic is a challenge since it depends upon LV end systolic dimension (LVESD) and LVEF which may be