Outcomes after mitral valve repair using a glutaraldehyde-fixed autologous pericardium

Objective This study aimed to evaluate the early- and mid-term outcomes of mitral valve repair using a glutaraldehyde-fixed autologous pericardium tailored using a ring sizer template. Methods We conducted a single-center, retrospective study of 43 adults who underwent mitral valve repair using glutaraldehyde-fixed autologous pericardium between April 2012 and December 2024. The repair techniques included leaflet perforation patch closure, leaflet augmentation, and en bloc reconstruction of the leaflet–chordae complex. The anatomical leaflet shape was replicated using a ring sizer for leaflet augmentation and reconstruction. Results The mean patient age was 59 ± 14 years, and 20 (47%) were female. Infective endocarditis was the primary pathology in 19 patients (44%). The repair types included patch closure (30%), leaflet augmentation (51%), and en bloc leaflet and chordal reconstruction (19%). Minimally invasive surgery was performed in 21% of patients. The in-hospital mortality was 1 (2%). At discharge, 34 (80%) of the patients had no or trivial mitral regurgitation, and no cases of moderate or severe regurgitation were observed. The mean follow-up was 4.4 years. Five-year survival was 93%, and 93% remained free from moderate or severe mitral regurgitation. Three patients (7%) required reoperation, two due to early hemolysis and one due to late regurgitation recurrence. Conclusions Mitral valve repair using a glutaraldehyde-fixed autologous pericardium demonstrated favorable early- and mid-term outcomes, suggesting good reproducibility and mid-term durability. The technique was effective in complex and reoperative cases, and was associated with low recurrence and reoperation rates. Follow-up is necessary to assess long-term durability.