Mechanisms of Repair Failure After Mitral Valve Repair Using Chordal Replacement

This study analyzed mechanisms of repair failure after mitral valve repair using chordal replacement and annuloplasty for degenerative mitral regurgitation. Between 2003 and 2010, 344 patients underwent mitral valve repair at the German Heart Center Munich. After a mean follow-up of 9.7 years, 38 patients (11 percent) required reoperation, with causes of failure being disease progression (39.5 percent), technical failure (38.8 percent), and endocarditis (18.4 percent). Re-repair was performed in 28.9 percent of cases, often involving redo annuloplasty or chordal replacement. Mitral valve replacement was needed in 63.2 percent of cases, particularly in patients with mitral valve sclerosis. Redo mitral valve repair was more common for technical failure, while mitral valve replacement was more often needed for valve sclerosis.