Rerepair for Mitral Insufficiency.
Publication/Presentation Date
2-1-2025
Abstract
BACKGROUND: Mitral valve repair provides superior outcomes to replacement for primary mitral regurgitation. Whether this is true after previous repair is unknown. This study presents the results of a strategy of rerepair for failed mitral valve repair. The study examined patients who were brought to the operating room for an intended mitral valve rerepair.
METHODS: Study investigators reviewed the last decade of institutional mitral valve databases at The University of Pennsylvania (Philadelphia, PA) and Baylor Scott & White The Heart Hospital - Plano (Plano, TX) and identified patients who underwent repeat mitral valve repair, in whom the index operation was mitral valve repair. The study analyzed their operative details and the clinical and echocardiographic outcomes.
RESULTS: Between 2008 and 2021, 71 patients (aged 61.5 ±10.7 years; 20% female) underwent mitral valve reoperation at an mean of 6.24 ± 7.62 years after an index mitral repair. A total of 20% of patients presented with New York Heart Association functional class III or IV symptoms. At the index operation, 34 patients (47.9%) had repair through a right minithoracotomy. Fifteen patients (21.1%) required the reoperation within 1 year. There were 0 early and 8 late deaths. One patient who underwent mitral replacement instead of repair required reoperation for paravalvular leak during the follow-up period. Three patients required mitral valve replacement at an average of 2.28 ± 2.03 years after initial mitral valve rerepair.
CONCLUSIONS: Mitral rerepair can be performed with acceptable results at a valve reference center. Durability and functional advantages of this approach remain to be proven.
Volume
119
Issue
2
First Page
370
Last Page
376
ISSN
1552-6259
Published In/Presented At
Rao, A., Shih, E., Szeto, W., Atluri, P., Acker, M., Hargrove, W. C., Hafen, L., Smith, R., & Ibrahim, M. (2025). Rerepair for Mitral Insufficiency. The Annals of thoracic surgery, 119(2), 370–376. https://doi.org/10.1016/j.athoracsur.2024.05.022
Disciplines
Medicine and Health Sciences
PubMedID
38830522
Department(s)
Department of Surgery
Document Type
Article