Atrial Fibrillation Worsens Outcome of Mitral Valve Repair for Degenerative Mitral Regurgitation: Long-Term Follow-Up of 959 Patients

This study analyzed the long-term outcomes in 959 patients with pre-existing atrial fibrillation (AF) who underwent mitral valve repair. Preexisting AF in degenerative mitral regurgitation (MR) marks advanced atrial disease and confers significantly worse 10-year survival and event-free survival after mitral repair, despite high rates of concomitant ablation, tricuspid repair, and left atrial appendage (LAA) exclusion. Patients with AF show more heart failure (HF) admissions, stroke, reinterventions, device therapy, and attenuated left atrial (LA) and tricuspid regurgitation (TR) reverse remodeling, supporting earlier surgery before sustained AF develops.