My wife has the same condition, but surgery has never even been suggested.  The only requirement she has is to take a specific atibiotic prior to going to the dentist. She was originally diagnosed in her 20's, and she is now age 50.

I'm not a doctor (and I didn't stay in *any* hotel last night :)), but the following thoughts occur to me:

1. Perhaps 30 years ago doctors were less likely to want to mess with heart issues.
2. It's possible at her younger age it was less of an issue than if she were diagnosed today.
3. I suppose there might be different severities of MVP?