Key result
Mitral valve repair is linked to ~5% greater LVEF improvement at 3 months versus replacement.
Why the study?
Despite the proven efficacy of surgical techniques for mitral regurgitation, early recovery of left ventricular systolic function and the tempo of reverse remodelling remain clinically important.
Does mitral valve repair improve early postoperative left ventricular ejection fraction more than mitral valve replacement in patients with severe mitral regurgitation?
Cohort (n=40)
No
Does mitral valve repair improve early postoperative left ventricular ejection fraction more than mitral valve replacement in patients with severe mitral regurgitation?
Answers are grounded in this paper and cite their sources.
Surgical correction of severe mitral regurgitation, particularly via valve repair, leads to significant early improvement in left ventricular ejection fraction within 3 months.
Mitral regurgitation is among the most prevalent disorders of the cardiac valvular apparatus and leads to chronic volume overload, left ventricular dilatation, and adverse ventricular remodelling. Despite the proven efficacy of contemporary surgical techniques for correcting mitral regurgitation, early recovery of left ventricular systolic function and the tempo of reverse remodelling remain clinically important. The aim of this study was to assess early postoperative changes in left ventricular systolic function and to analyse the dynamics of ejection fraction as a marker of the effectiveness of surgical correction of mitral regurgitation. The study enrolled 40 patients with grade III-IV mitral regurgitation who underwent either mitral valve repair (45%) or mitral valve replacement (55%). Transthoracic echocardiography was performed three times – preoperatively and at 1 and 3 months after surgery. Ejection fraction was calculated using the biplane Simpson method in accordance with ASE/EACVI recommendations. Statistical analysis was performed using built-in Microsoft Excel tools with computation of means, standard deviations, and percentage changes. Preoperatively, mean ejection fraction was 48.2%. At 1 month, it increased to 51.7%, and at 3 months to 54.9%, consistent with early reverse remodelling. The most pronounced improvement was observed in patients with a baseline ejection fraction <50% (increase of 8-10%). Mitral valve repair was associated with more favourable early dynamics than replacement (7-9% vs 5-6%). Overall, 75% of patients demonstrated a positive trajectory as early as one month postoperatively. Surgical correction of mitral regurgitation is associated with a substantial early improvement in left ventricular systolic function. Ejection fraction dynamics within the first 1-3 postoperative months represent an important prognostic tool, enabling assessment of procedural efficacy, the rate of reverse remodelling, and optimisation of subsequent patient management Received: 04.01.2026 | Revised: 17.04.2026 | Accepted: 26.05.2026
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Kostiv et al. (2026) conducted a cohort in Grade III-IV mitral regurgitation (n=40). Mitral valve repair vs. Mitral valve replacement was evaluated on Left ventricular ejection fraction (LVEF) at 3 months (MD 4.6%, p=<0.01). Mitral valve repair resulted in a significantly greater improvement in left ventricular ejection fraction at 3 months compared to mitral valve replacement (mean difference 4.6%, p<0.01).
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