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Updated: Jul 1, 2026
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Minimally invasive mitral valve repair revisited: Respect or Resect? Amidst competing risks
R W Brooks1, P Biaggi2, O Gaemperli2
1University of Zurich, Rämistrasse 71, Zurich, 8006, Switzerland. raphaelwilliam.brooks@uzh.ch.
Journal of Cardiothoracic Surgery
|June 30, 2026
Summary
Mitral valve repair (MVr) techniques, including leaflet preservation or resection, show similar long-term outcomes for degenerative mitral regurgitation (DMR). This minimally invasive approach is effective even for complex cases.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Minimally Invasive Surgery
Background:
- Mitral valve repair (MVr) is preferred over mitral valve replacement (MVR) for degenerative mitral regurgitation (DMR).
- Debate exists regarding optimal MVr strategies: leaflet preservation ('Respect'), resection ('Resect'), or combined ('Both').
- Comparison of longer-term outcomes for these techniques in complex cases is needed.
Purpose of the Study:
- To compare longer-term outcomes of different MVr techniques in minimally invasive surgery.
- To evaluate valve performance, reoperation rates, mortality, and MACCE in a real-world cohort with complex pathologies.
Main Methods:
- Retrospective analysis of 447 consecutive patients undergoing isolated MVr via mini-thoracotomy (2006-2014).
- Patients stratified into 'Respect', 'Resect', or 'Both' repair groups.
- Primary endpoints: freedom from reoperation, mitral regurgitation severity. Secondary endpoints: mortality, MACCE. Competing risk regression used.
Main Results:
- At 5-year follow-up, 88.4% had durable valve competence (MR grade ≤ I).
- Five-year freedom from reoperation (93.3%), survival (94.0%), and MACCE (96.8%) showed no significant differences between techniques.
- Competing risk analysis confirmed no significant intergroup differences.
Conclusions:
- All three MVr techniques ('Respect', 'Resect', 'Both') yield comparable longer-term outcomes in minimally invasive surgery.
- These results extend to complex degenerative mitral valve pathologies.
- A morphology-guided, individualized surgical approach is a reliable standard for DMR management.
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