TY - JOUR
T1 - Mechanisms of Repair Failure After Mitral Valve Repair Using Chordal Replacement
AU - Lang, Miriam
AU - Feirer, Nina
AU - Voss, Bernhard
AU - Geirsson, Arnar
AU - Amabile, Andrea
AU - Krane, Markus
AU - Vitanova, Keti
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/2
Y1 - 2025/2
N2 - Background: Mechanisms of repair failure after mitral valve repair (MVr) using chordal replacement and annuloplasty for degenerative mitral regurgitation were analyzed. Methods: All mitral valve reoperations after isolated MVr using solely chordal replacement and annuloplasty for degenerative mitral regurgitation at the German Heart Center Munich (Munich, Germany) were reviewed. This retrospective observational study aimed to analyze mechanisms of repair failure leading to reoperations. Results: Between 2003 and 2010, a total of 344 patients underwent MVr with chordal replacement and annuloplasty. During a mean follow-up of 9.7 years (range, 0-15.9 years), reoperation on the mitral valve was necessary in 38 (11.0%) cases. Reoperations were performed after a mean of 6.8 years (range, 0-14.1 years). The mechanisms of MVr failure were disease progression (39.5%), technical failure (36.8%), and endocarditis (18.4%). Re-repair was performed in 28.9% and was accomplished using redo annuloplasty (90.9%), chordal replacement (90.9%), resection techniques (27.3%), and leaflet patch reconstruction (9.1%). One patient (2.6%) underwent transcatheter edge-to-edge repair for reoperation. Mitral valve replacement (MVR) was necessary in 63.2%. Redo MVr was mainly performed in cases of technical failure, and MVR was more frequently performed in patients with mitral valve sclerosis. Repeat reoperation was necessary in 3 of 24 cases of MVR and in 2 of 11 cases of redo MVr after a median of 3.8 years (range, 0.01-10.04 years). Conclusions: MVr using chordal replacement allows a variety of methods for re-repair, including transcatheter solutions. Redo MVr is more often feasible in cases of technical failure, whereas MVR for reoperation is more frequently necessary in patients with mitral valve sclerosis.
AB - Background: Mechanisms of repair failure after mitral valve repair (MVr) using chordal replacement and annuloplasty for degenerative mitral regurgitation were analyzed. Methods: All mitral valve reoperations after isolated MVr using solely chordal replacement and annuloplasty for degenerative mitral regurgitation at the German Heart Center Munich (Munich, Germany) were reviewed. This retrospective observational study aimed to analyze mechanisms of repair failure leading to reoperations. Results: Between 2003 and 2010, a total of 344 patients underwent MVr with chordal replacement and annuloplasty. During a mean follow-up of 9.7 years (range, 0-15.9 years), reoperation on the mitral valve was necessary in 38 (11.0%) cases. Reoperations were performed after a mean of 6.8 years (range, 0-14.1 years). The mechanisms of MVr failure were disease progression (39.5%), technical failure (36.8%), and endocarditis (18.4%). Re-repair was performed in 28.9% and was accomplished using redo annuloplasty (90.9%), chordal replacement (90.9%), resection techniques (27.3%), and leaflet patch reconstruction (9.1%). One patient (2.6%) underwent transcatheter edge-to-edge repair for reoperation. Mitral valve replacement (MVR) was necessary in 63.2%. Redo MVr was mainly performed in cases of technical failure, and MVR was more frequently performed in patients with mitral valve sclerosis. Repeat reoperation was necessary in 3 of 24 cases of MVR and in 2 of 11 cases of redo MVr after a median of 3.8 years (range, 0.01-10.04 years). Conclusions: MVr using chordal replacement allows a variety of methods for re-repair, including transcatheter solutions. Redo MVr is more often feasible in cases of technical failure, whereas MVR for reoperation is more frequently necessary in patients with mitral valve sclerosis.
UR - http://www.scopus.com/inward/record.url?scp=85212436917&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2024.10.029
DO - 10.1016/j.athoracsur.2024.10.029
M3 - Article
C2 - 39603581
AN - SCOPUS:85212436917
SN - 0003-4975
VL - 119
SP - 362
EP - 369
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 2
ER -