Impact of resection vs respect techniques on left ventricular function after mitral valve repair: a systematic review

Objective: Mitral valve disease, ranging from degenerative to infective origin, is one of the most prevalent left heart diseases globally and affects a large number of individuals. Conventionally, surgical repair has grown to become the treatment of choice, with two main techniques being resection and respect. Current literature has yet to address which technique is superior to the other, particularly in regard to left ventricular (LV) function. Methods: We performed a systematic review and meta-analysis on three databases with a primary outcome of LV function alongside its’ parameters, and a secondary outcome of repair durability, mitral valve gradient, and mortality rates. Meta-analysis was performed using random effects, and results were displayed in forest plots. Risk of bias was conducted using the Newcastle-Ottawa Scale. Results: Six retrospective studies were included, evaluating a total of 3376 patients. Pooled results showed that LV function were preserved equally in both groups, showing no statistically significant differences. The respect group had slightly lower mortality rates in comparison to the resect group, and the repair success rate showed a slight superiority in the respect group. Significant heterogeneity was observed on left atrial diameter (LAD) measurement, indicating variability. The overall differences in LV function coming from both techniques appear intangible. Plenty of consideration must be made beyond LV function in determining which repair technique should be performed on a patient. Conclusion: This study demonstrated that both the resect and respect techniques were found to be equally excellent in preserving left ventricular function after mitral valve repair.