Overview
Prosthetic mitral valve failure can occur due to various reasons, necessitating revision surgery. Mitral valve repair (MVr) may offer superior long-term survival and freedom from valve-related complications compared to mitral valve replacement for primary mitral regurgitation 1.Diagnosis
Management
Mitral valve repair (MVr) approaches include chordal replacement ("respect") and leaflet resection ("resect") 1.
The "respect" approach was associated with superior survival compared to the "resect" approach in an overall sample, but not in a risk-adjusted sample 1.
No difference was found between the "respect" and "resect" approaches in the rate of mitral regurgitation recurrence in either the overall or risk-adjusted samples 1.
Reoperation rates did not differ between the "respect" and "resect" approaches in the overall sample 1.Special Populations
Key Recommendations
Mitral valve repair (MVr) may be associated with superior long-term survival and freedom from valve-related complications compared with mitral valve replacement for primary mitral regurgitation 1. (Evidence: Moderate)
The chordal replacement ("respect") approach for mitral valve repair may be associated with superior survival compared to the leaflet resection ("resect") approach in an overall patient sample 1. (Evidence: Moderate)
There is no significant difference in the rate of mitral regurgitation recurrence between the "respect" and "resect" approaches for mitral valve repair 1. (Evidence: Moderate)
Reoperation rates do not appear to differ between the "respect" and "resect" approaches for mitral valve repair 1. (Evidence: Moderate)References
1 Caldonazo T, Sá MP, Jacquemyn X, Van den Eynde J, Kirov H, Harik L et al.. Respect Versus Resect Approaches for Mitral Valve Repair: A Meta-Analysis of Reconstructed Time-to-Event Data. The American journal of cardiology 2024. link