Related Experiment Video
Updated: Dec 6, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis
Muthu Veerappan1,2, Prashasth Cheekoty1,3, Faizus Sazzad1,4,5
1Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, National University Health System-NUHS, 1E Kent Ridge Road, 9th Floor, Tower Block, Singapore, 119228, Singapore.
Background:
The optimal treatment strategy following a failed mitral valve repair remains unclear. This study aims to compare and analyse available studies which report the clinical outcomes post mitral valve re-repair (MVr) or replacement (MVR) after a prior mitral valve repair.
Methods:
Based on PRISMA guidelines, a literature search was performed utilising PubMed, Cochrane and Scopus databases to identify retrospective cohort studies that reported outcomes of MVr and MVR after a prior mitral valve repair. Data regarding operative mortality, clinical outcomes and complications were extracted, synthesized and meta-analysed where appropriate.
Results:
Eight studies with a total cohort of 1632 patients were used. After analysis, no significant differences in the short term and long-term operative mortality, incidence of stroke, congestive heart failure, Grade 1 and Grade 2 mitral regurgitation, requirement of 3rd mitral valve operation and reoperation due bleeding were found between the two groups. However, a slightly higher incidence of postoperative atrial fibrillation (OR: 0.11, CI: 0.02 to 0.17, I2 = 0%, p = 0.02) was observed in the MVR group, as compared to the MVr group.
Conclusion:
MVr appears to be a viable alternative to MVR for mitral valve reoperation, given that they are associated with similar post-operative outcomes.
Related Concept Videos
Mitral Stenosis III: Medical Management
Mitral Regurgitation III: Medical Management
Mitral Valve Prolapse II: Assessment and Management
Mitral Regurgitation I: Introduction
Mitral Valve Prolapse I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests

