Beyond the 10-Year Horizon: Long-Term Outcome of Mitral Valve Repair Using Chordal Replacement

Objectives: The long-term results of mitral valve repair using “non-resection” techniques (annuloplasty ring and chordal replacement) for degenerative mitral valve regurgitation (DMR) were investigated.

Methods: All consecutive patients with DMR, who underwent mitral valve repair with chordal replacement between 2003 and 2010 in the German Heart Centre Munich, were reviewed. Endpoints of the study were survival, freedom from MV-reoperation and freedom from recurrent MR > II degrees. The mean follow-up was 9.38 ± 3.45 years.

Result: A total of 344 patients met the inclusion criteria. The mean age of patients was 59.0 ± 11.9 years. 73.4% of patients presented with third degree MR and 25.2% with fourth degree MR. Isolated prolapse of the posterior leaflet was most common with 71.6%, while isolated anterior leaflet prolapse was present in 11.0% and bileaflet prolapse was present in 17.3%. 36.6% of the patients received 2 and 37.3% 3 neochordae, respectively; 26.6% received 4 or more neochordae. Overall 10-year survival was 82.5 ± 2.2%. Overall 30-day mortality was 0.87% (3 of 344). At 10 years, freedom from recurrent MR > II° was 87.6% ± 2.0%, and freedom from reoperation on the mitral valve was 89.1% ± 1.8%. Overall 15-year survival was 76.5 ± 2.9%. At 15 years, freedom from MR > II degrees was 72.5% ± 5.6%, and freedom from reoperation was 76.4% ± 5.7%.

Conclusion: Chordal replacement is an effective method for mitral valve repair and provides stable long-term results with low rates of recurrent MR and reoperations on the mitral valve.

Publication History

Article published online:
19 February 2021