Key result
Mitral valve repair links to better long-term survival and lower morbidity versus replacement.
Why the study?
Long-term outcomes of mitral valve repair versus replacement needed investigation in patients with degenerative mitral regurgitation undergoing surgery without concomitant procedures.
Does isolated mitral valve repair improve long-term survival and reduce postoperative morbidity compared to mitral valve replacement in patients with degenerative mitral regurgitation?
Cohort (n=1,493)
Yes
Does isolated mitral valve repair improve long-term survival and reduce postoperative morbidity compared to mitral valve replacement in patients with degenerative mitral regurgitation?
Effect estimate: HR > 1.0
p-value: p=<.001
Isolated mitral valve repair is associated with better long-term survival and lower postoperative morbidity compared to mitral valve replacement in patients with degenerative mitral regurgitation, regardless of age.
Repair may be preferable in degenerative MR; leaves open need for RCTs to confirm survival benefit.
Objective: This study was performed to investigate the long-term outcomes in patients with degenerative mitral regurgitation (MR) undergoing mitral valve repair (MVr) versus mitral valve replacement (MVR) without concomitant surgeries. Methods: The study cohort comprised 1493 patients with degenerative MR who were treated with isolated mitral valve surgery between January 2000 and December 2017 in a large multicenter (5 hospitals) registry of the Province of British Columbia, Canada, including 991 with repair and 502 with replacement. A propensity-matched comparison and risk-adjusted model were used to analyze the outcomes. Results: < .001). The HR of MVR over MVr remained consistently greater than 1.0 across all ages. Conclusions: MVr is associated with lower postoperative morbidity and better long-term survival compared with MVR in patients undergoing isolated mitral valve surgery for degenerative MR. The benefit of MVr appears age-independent.
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Kakuta et al. (2023) conducted a cohort in Degenerative mitral regurgitation (n=1,493). Mitral valve repair vs. Mitral valve replacement was evaluated on Long-term survival and postoperative morbidity (HR > 1.0, p=<.001). Mitral valve repair was associated with better long-term survival and lower postoperative morbidity compared with mitral valve replacement for degenerative mitral regurgitation (P<.001).
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