Mitral Valve Repair Versus Replacement: Comparative Outcomes in Functional Mitral Regurgitation

Clinical therapy of functional mitral regurgitation (FMR), a common consequence in patients with heart failure and other cardiac diseases, can be very challenging. The purpose of this study is to evaluate the outcomes of mitral valve replacement (MVR) and repair (MVr) in patients with FMR, with an emphasis on postoperative complications, functional recovery, survival rates, and recurrence of regurgitation. Studies published between 2000 and 2024 that assessed surgical outcomes for FMR were included in an extensive search of PubMed, Scopus, and the Cochrane Library, with particular focus on randomized controlled trials, cohort studies, and meta-analyses. Adult patients with ischaemic and nonischemic FMR receiving either MVr or MVR were the primary focus of the inclusion criteria. In addition to assessing short- and long-term postoperative outcomes, the study also examined variables that influence surgical decision-making, including patient comorbidities, valve pathology, and left ventricular function. By summarizing the most recent data, this study provides a comprehensive overview of the relative effectiveness of MVr and MVR in the treatment of FMR.