Late Outcomes After Second Repair (Re-repair) for Degenerative Mitral Valve

Objective: Due to the advantages of mitral valve repair, it becomes the procedure of choice for mitral regurgitation. Surgeons have to deal in the future with increasing number of patients with recurrent regurgitation after repair. We report our experience in reoperation for late failure of mitral valve repair.

Methods: From 2004 to 2014, twenty-two consecutive selective patients with recurrent mitral regurgitation after primary mitral valve repair underwent mitral valve re-repair at our department. The mean age was 54±12 years, and 17 (77%) were male.

Results: The mean duration from initial repair to reoperation was 8.2±4.1 years. The main indications for reoperation were regurgitation (n=19), endocarditis (n=2) and obstruction from systolic anterior motion (n=1). There was no intra- and early postoperative mortality. No major complications were reported at early follow-up. The mean cardiopulmonary bypass and cross-clamp time were 111±45 and 79±34 minutes. The mean hospital stay was 6±3 days. At follow up (64±32months),80% of the patients were in NYHA FC I/II and None of the patients needed recurrentmitral reoperation . Echocardiographic follow-up demonstrated 100% freedom from recurrent 3+ MR , significant improvement of left ventricular end diastolic and systolic diameter ( LVEDD decreased from 5.5±0.7 mm preoperatively to 5±0.5 mm postoperatively, p=<0.05)

Conclusion: Mitral valve re-repair is safe and can be durable in selected patients. It should be considered in young patients (<60y) with recurrent MR after repair.