Mid-Term Results of Transventricular Mitral Valve Repair: Single Centre Experience

Structured Abstract Objective To evaluate mid-term outcomes of transventricular mitral valve (MV) repair and its association with initial anatomy of the MV. Methods This non-randomized observational study included 88 patients (mean age 60 years; 69% men) who underwent transventricular MV repair for severe degenerative mitral regurgitation (MR) between 2011 and 2017. MV function was assessed by echocardiography at 1, 6 months and annually after the procedure. According to the location of MV pathology, all patients were stratified into four anatomical types (A, B, C, and D). Results were assessed using Kaplan-Meier method, mixed-effects continuation ratio model, and multivariable Cox regression. Results Median follow-up of 42 months (IQR 27-55) was complete for 83 patients (94.3%). There were 3 late deaths: two cardiac and one non-cardiac. Recurrent MR>2+ was observed in 29 patients (33%), 18 patients (20.5%) underwent repeat surgery. Device success was 82% in type A patients at 6 months and thereafter; 87%, 85%, and 75% at 6, 12, and 36 months in type B; 53% at 1 month and 20% at 24 months in type C group. Probability of postoperative MR progression was higher in patients with greater preoperative LVEDD, type B, and type C pathology (p Conclusions Initial acceptable MR reduction following transventricular MV repair of isolated P2 prolapse was possible but found durable in only 82% at three years. Higher risk of MR recurrence occurred with complex degenerative pathology.