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Updated: Jan 6, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Isolated Mitral Valve Repair in Patients with Reduced Left Ventricular Ejection Fraction
Thilo Noack1, Mateo Marin Cuartas1, Philipp Kiefer1
1University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
Purpose:
This study aims to analyze the clinical outcomes after isolated mitral valve (MV) repair in patients with reduced left ventricular ejection fraction (LVEF <50%) with focus on perioperative characteristics, survival, and freedom from reoperations.
Methods:
Between 1997 and 2015, 557 patients with reduced LVEF (age: 62.8 ± 11.7 years, male: 320) underwent MV repair for symptomatic mitral regurgitation (MR). Etiologies were dilated non-ischemic cardiomyopathy and ischemic cardiomyopathy in 487 (87.4%) and 70 (12.6%) patients, respectively; these were classified into three different subgroups: LVEF 40%-49% (group 1), 30%-39% (group 2), and <30% (group 3).
Results:
Overall, 294, 145, and 118 patients had an LVEF of 40%-49%, 30%-39%, and <30%, respectively. Logistic EuroSCORE was significantly higher (P <0.001) as the LVEF worsened. The survival analysis for groups 1-3, respectively, revealed the following: 30-day mortality: 1.4%, 3.4%, and 7.6% (P <0.001); 1-year survival: 93.9%, 89.4%, and 82% (P <0.001); 5-year survival: 81.2%, 75.2%, and 58% (P <0.001).
Conclusion:
MV repair in patients with impaired LVEF could be performed safely with good clinical short- and mid-term outcome. Nevertheless, reduced preoperative LVEF correlates with worse perioperative and long-term survival.
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