Mitral valve repair of the posterior leaflet: Results and 20-year follow-up

Introduction and objectives: Mitral valve repair is the gold standard treatment of degenerative mitral regurgitation. The objective of this study is to evaluate the very long-term results of mitral valve repair for posterior leaflet prolapse in our center. Methods: Retrospective study of all consecutive patients with severe degenerative mitral regurgitation due to posterior leaflet prolapse operated in our center (2001-2021). Surgical techniques and results, and clinical and echocardiographic follow-up were recorded. Results: A total of 260 patients were operated (mean age 65.3 +/- 12.4 years, men 67.7%). Isolated resection techniques were used in 185 patients (71.2%), neochords in 53 (20.4%) and other techniques in 15 (5.8%). Successful repair rate was 97.3%. Tricuspid annuloplasty was performed in 45 patients (17.3%). Hospital mortality was 1.5%. The mean follow-up was 6.6 +/- 5 years (0-20). Actuarial survival was 51.3% at 20 years, with a mean age of the patients at the time of death of 82.1 +/- 7.2 years. The freedom of recurrent grade >= II mitral regurgitation and reoperation at 20 years were 59.2% and 97.7% respectively. Worse freedom of recurrent mitral regurgitation and reoperation were observed in the neochord repair compared to resection techniques (P =.001 and P =.002, respectively). Conclusions: Long-term results of mitral valve repair of posterior leaflet prolapse in our center have been excellent. Resective techniques seem to be related with greater long-term durability than neochord implantation. (c) 2022 Sociedad Espanola de Cirug ia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).