Journal of cardiothoracic and vascular anesthesia
August 24, 2026 · via Europe PMC
Outcomes of Patients Undergoing Mitral Valve Replacement After Failed Attempt at Mitral Valve Repair.
Ogami T, Chetkof E, Bonatti JO, +6 more, Sultan I
AI summary — for doctors, generated from the abstract only
Mitral valve replacement after a failed repair attempt in the same operation had similar outcomes to planned replacement, though operative times were longer.
What was studied
Single-institution retrospective study of 1661 patients undergoing mitral valve replacement from 2010 to 2024, comparing those in whom repair was attempted first (intended repair) with planned replacement.
Key findings
- Repair was attempted in 133 patients (8%), and 1528 (92%) had planned replacement.
- Planned replacement patients more often had endocarditis history (23.8% v 15.0%) and prior sternotomy (32.1% v 15.8%).
- Postoperative outcomes were similar despite longer operative times in the intended repair group.
Clinical relevance
Surgeons may feel more comfortable attempting repair in suitable anatomy, since a failed attempt did not appear to harm patients.
Who should care
Limitations
The abstract is cut off, so outcome rates and confidence intervals are absent. The study is retrospective and single-center, and the groups differed at baseline.
Trying repair first did not worsen outcomes when replacement was needed.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVES
Mitral valve repair (MVr) is the ideal treatment strategy for degenerative mitral regurgitation. Mitral valve replacement (MVR) may be required if MVr is unsuccessful during the index surgery. The consequences of MVR following failed MVr during the same surgery are unclear.
DESIGN
Retrospective observational study.
SETTING
Single institution, university affiliated.
PARTICIPANTS
All patients who underwent MVR from 2010 through 2024 were included. Patients with concomitant surgeries were included.
INTERVENTIONS
Patients were dichotomized into the intended repair (IR) or de novo replacement (DR) groups based on the intended procedure.
MEASUREMENTS AND MAIN RESULTS
A total of 1,661 patients (mean age, 64 years; 57% female) underwent MVR. MVr was attempted in 133 patients (8%, IR group), and 1,528 underwent planned MVR (92%, DR group). The mean ejection fraction was 55%. Female sex (58.0% in the DR group v 48.9% in the IR group, p = 0.04), history of infective endocarditis (23.8% v 15.0%, p = 0.02), history of cerebrovascular disease (32.1% v 19.5%, p = 0.03), and prior sternotomy (32.1% v 15.8%, p < 0.001) were more prevalent in the DR group. After propensity score matching, perioperative morbidity and mortality were similar. The median cardiopulmonary bypass time and cross-clamp time were longer in the IR group (207 minutes v 134 minutes in the DR group and 163 minutes v 102 minutes in the DR group, respectively). Kaplan-Meier curve analysis showed similar 5-year survival (p = 0.91).
CONCLUSIONS
Postoperative outcomes were similar despite longer operative times in the IR group. Failure of initial MVr, leading to MVR, did not translate into adverse early or long-term outcomes. These findings suggest that repair may be more aggressively considered in patients with repairable anatomies.
DOI
10.1053/j.jvca.2026.08.146
PMID
42881054
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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