What Is the 10-Year Reoperation Rate After Mitral Valve Repair for Degenerative Disease?

Mitral valve repair (MVR) remains the gold standard treatment for severe degenerative mitral regurgitation (MR), owing to its superior outcomes compared with valve replacement.1 However, long-term durability and reoperation rates are essential for patient counselling and clinical decision-making. Five-year freedom from reoperation ranges from 97% to 98%,2,3 with cumulative reoperation rates at 5, 10, and 20 years reported as 2%, 3%, and 6% respectively.2,3 Over time, recurrence of at least moderate-to-severe MR occurs in 6.3% and 12.5% of patients at 10 and 20 years, respectively.2 At 10 years post-repair most patients maintain excellent clinical status and quality of life, with 10-year survival ranging from 85% to 89%2,3 and 10-year freedom from rehospitalization for heart failure of 92%.3 These data confirm the long-term efficacy and durability of MVR for degenerative MR when performed in high-volume centres. Several predictors have been associated with an increased risk of mitral valve reintervention. These include anterior leaflet disease, lack of annuloplasty ring implantation, tendency to systolic anterior motion at discharge, the need for a second cardiopulmonary bypass run, and residual mild-to-moderate MR at hospital discharge.3,4