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Updated: Jul 20, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
[Mitral valve repair for mitral regurgitation]
Rocío García-Orta1, Eduardo Moreno-Escobar, María F Ruiz-López
1Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, España. eduroc@telefonica.net
Insights
Mitral valve repair offers good outcomes for severe mitral regurgitation, particularly in myxomatous degeneration cases. Success rates were higher for isolated posterior cusp degeneration compared to bicuspid involvement.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Thoracic Medicine
Context:
- Severe mitral regurgitation (MR) poses significant clinical challenges.
- Mitral valve repair is a preferred surgical option over replacement when feasible.
- Understanding outcomes based on etiology and specific valve pathology is crucial.
Purpose:
- To evaluate the efficacy and outcomes of mitral valve repair in patients with severe mitral regurgitation.
- To identify factors influencing successful repair and long-term results.
Summary:
- Eighty-one patients with severe MR underwent mitral valve repair; common etiologies included myxomatous degeneration (66.6%), ischemic disease (11%), and chordal rupture (8%).
- Overall surgical mortality was 7%. During a mean 30-month follow-up, 11 patients had recurrent MR (≥2/4).
- A good outcome (survival without prosthesis, complications, or significant MR) was achieved in 78% of myxomatous degeneration cases versus 48% of other etiologies (P=.023).
Impact:
- Mitral valve repair demonstrates high success rates, especially in myxomatous degeneration, highlighting its therapeutic value.
- Isolated posterior cusp degeneration showed better outcomes (85%) than bicuspid degeneration (70%), informing surgical strategy.
- These findings support the continued use and refinement of mitral valve repair techniques for severe MR.
Abstract:
We analyzed the results of mitral valve repair in 81 consecutive patients with severe mitral regurgitation. Of these patients, 66.6% had myxomatous degeneration, 11% ischemic disease, 8% chordal rupture, 5% congenital disease, and 3.7% endocarditis. Repair could not be achieved in five patients, and valve replacement was necessary. Six died during surgery (mortality 7%). During follow-up (mean 30 [8] months), there was one death due to refractory ischemic heart failure and mitral regurgitation (>or= 2/4) was observed in 11 patients. A good result (i.e., survival without a prosthesis, major complications, or mitral regurgitation >1/4) was obtained in 78% of patients with myxomatous degeneration versus 48% of those with other etiologies (P=.023). A good result was obtained more frequently in cases of isolated posterior cusp degeneration than in those involving degeneration of both cusps (85% vs 70%; P=.03).
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