In patients with degenerative mitral regurgitation, mitral valve repair was associated with lower in-hospital mortality compared to replacement (1.4% vs 6.2%, P<0.0001).
Observational (n=2,135)
Yes
What are the contemporary surgical outcomes and repair rates for degenerative mitral regurgitation in real-world practice?
In a contemporary real-world registry, mitral valve repair for degenerative MR achieved high rates (80%) and low in-hospital mortality, though outcomes varied by center volume and patient complexity.
Absolute Event Rate: 1.4% vs 6.2%
p-value: p=<0.0001
OBJECTIVE: Degenerative mitral valve (MV) disease is the leading mitral regurgitation (MR) etiology in Western countries, representing a significant health burden. With the rise of transcatheter therapies, real-world data on surgical management, repair rates, outcomes, and center-level practices are increasingly needed. METHODS: From MITRACURE, a multicenter registry of 40 centers across Canada and France of consecutive adult patients who underwent surgery for MR in 2019, we selected the subset of patients with degenerative MR. RESULTS: MV surgery was performed in 2,135 patients with degenerative MR (70% male, 65±12 years); 37% were in NYHA III/IV, only 17% were considered asymptomatic, and early intervention was performed in only 4%. MV repair rate was 80%, with a 6% intraoperative repair failure rate. In-hospital mortality was 2.3%, 1.4% for repair vs 6.2% for replacement, P<0.0001. Major complications occurred in 20%, higher for replacement and combined procedures. Independent predictors of mortality included NYHA III/IV, type of surgery, and EuroSCORE II. Repair rates declined with age, comorbidities, and complex anatomy, and increased with center volume (68%, 77%, and 84% in low, intermediate, and high-volume centers, respectively; P<0.0001). Sex was not associated with repair rates after adjustment. CONCLUSIONS: In this large real-world cohort from two publicly funded healthcare systems, many patients with degenerative MR were referred late for surgery, and early intervention was rare. While in-hospital mortality was low overall, outcomes varied across subgroups. MV repair declined with age and MV anatomical complexity. High-volume centers had better outcomes, supporting earlier referral, structured pathways, and surgical centralization to optimize care.
Bouchard et al. (Fri,) conducted a observational in Degenerative mitral regurgitation (n=2,135). Mitral valve repair vs. Mitral valve replacement was evaluated on In-hospital mortality (p=<0.0001). In patients with degenerative mitral regurgitation, mitral valve repair was associated with lower in-hospital mortality compared to replacement (1.4% vs 6.2%, P<0.0001).