Outcomes after mitral valve repair using a glutaraldehyde-fixed autologous pericardium

This study aimed to evaluate the early- and mid-term outcomes of mitral valve repair using a glutaraldehyde-fixed autologous pericardium tailored using a ring sizer template.

We conducted a single-center, retrospective study of 43 adults who underwent mitral valve repair using glutaraldehyde-fixed autologous pericardium between April 2012 and December 2024. The repair techniques included leaflet perforation patch closure, leaflet augmentation, and en bloc reconstruction of the leaflet-chordae complex. The anatomical leaflet shape was replicated using a ring sizer for leaflet augmentation and reconstruction.

The mean patient age was 59 ± 14 years, and 20 (47%) were female. Infective endocarditis was the primary pathology in 19 patients (44%). The repair types included patch closure (30%), leaflet augmentation (51%), and en bloc leaflet and chordal reconstruction (19%). Minimally invasive surgery was performed in 21% of patients. The in-hospital mortality was 1 (2%). At discharge, 34 (80%) of the patients had no or trivial mitral regurgitation, and no cases of moderate or severe regurgitation were observed. The mean follow-up was 4.4 years. Five-year survival was 93%, and 93% remained free from moderate or severe mitral regurgitation. Three patients (7%) required reoperation, two due to early hemolysis and one due to late regurgitation recurrence.

Mitral valve repair using a glutaraldehyde-fixed autologous pericardium demonstrated favorable early- and mid-term outcomes, suggesting good reproducibility and mid-term durability. The technique was effective in complex and reoperative cases, and was associated with low recurrence and reoperation rates. Follow-up is necessary to assess long-term durability.