Outcomes of Leaflet Resection vs Chordal Replacement for Degenerative Mitral Regurgitation.

Background: Debate persists regarding the outcomes of leaflet resection (RESECT) vs chordal replacement (CHORD) for degenerative mitral regurgitation. Our aim was to compare early and late outcomes of the RESECT vs CHORD techniques for degenerative mitral regurgitation.

Methods: A total of 1066 consecutive patients undergoing mitral repair for degenerative regurgitation with the RESECT vs CHORD techniques were evaluated from a prospectively maintained database.

Late Outcomes of Porcine and Pericardial Bioprostheses After Mitral Valve Replacement in 1162 Patients.

Background: Debate continues regarding the superiority of porcine vs pericardial bioprostheses, and data relevant to this comparison are scant. This study compared late survival and structural valve deterioration of porcine and pericardial mitral valve prostheses.

Methods: Adults undergoing mitral valve replacement with 1 first-generation porcine valve model and 1 pericardial valve line were reviewed from a prospectively maintained institutional database between 1976 and 2020.

Infarct exclusion repair of postmyocardial infarction ventricular septal rupture with a hybrid patch and septal occluder device compared with patch only.

Objective: We developed a hybrid technique for repairing post-myocardial infarction (MI) ventricular septal defect (VSD) that combines infarct exclusion with patch and a nitinol-mesh septal occluder device (SOD) to provide a scaffold to support the damaged septal wall. Here, we compare outcomes of patients with post-MI VSD repaired using patch only or hybrid patch/SOD.

Methods: Patients undergoing post-MI VSD repair at our institution from 2013 to 2022 who received patch alone or patch/SOD repair were analyzed.

Late Survival After Redo Mitral Operation With Minithoracotomy Compared With Sternotomy.

Background: The long-term effectiveness of minithoracotomy over redo median sternotomy for reoperative mitral operation is not well described. Here we present long-term survival after reoperative mitral operation based on operative approach.

Methods: Adults undergoing mitral valve operation with previous sternotomy by redo sternotomy and minithoracotomy were reviewed from our prospectively maintained institutional database from 1997 to 2022.

Effect of Tricuspid Repair on Pacemaker Rate After Mitral Repair Is Higher in Degenerative Disease.

Background: Permanent pacemaker (PPM) placement after mitral valve (MV) repair is affected by concomitant procedures, yet existing literature reports conflicting rates. We aimed to characterize the effect of concomitant operation on risk of need for postoperative PPM in patients who underwent MV repair.

Methods: A retrospective review of a prospectively maintained institutional database (1996-2020) was conducted of consecutive patients undergoing MV repair, including concomitant procedures.

Long-term outcomes of phenoclusters in severe tricuspid regurgitation.

Aims: Severe tricuspid regurgitation (TR) exhibits high 1-year morbidity and mortality, yet long-term cardiovascular risk overall and by subgroups remains unknown. This study characterizes 5-year outcomes and identifies distinct clinical risk profiles of severe TR.

Methods And Results: Patients were included from a large US tertiary referral center with new severe TR by echocardiography based on four-category American Society of Echocardiography grading scale between 2007 and 2018.

Impact of Transcatheter Mitral Valve Repair Availability on Volume and Outcomes of Surgical Repair.

Background: The impact of transcatheter edge-to-edge repair (TEER) on national surgical mitral valve repair (MVr) volume and outcomes is unknown.

Objectives: This study aims to assess the impact of TEER availability on MVr volumes and outcomes for degenerative mitral regurgitation.

Methods: MVr volume, 30-day and 5-year outcomes, including mortality, heart failure rehospitalization and mitral valve reintervention, were obtained from the Society of Thoracic Surgeons database linked with Medicare administrative claims and were compared within TEER centers before and after the first institutional TEER procedure.

The outcome of mitral repair for degenerative versus ischemic mitral regurgitation using a single complete ring.

Background: The durability of surgical repair for degenerative versus ischemic mitral regurgitation (MR) is thought to be markedly different. We, therefore, examined late outcomes and durability for mitral repair in a large cohort of patients receiving a single annuloplasty device.

Methods: A total of 749 consecutive patients receiving mitral repair for degenerative mitral regurgitation (DMR) or ischemic mitral regurgitation (IMR) were evaluated from a prospective database.

Bicuspid aortic valve repair: An ongoing struggle in material science.

Background: Techniques and results of aortic valve repair remain challenging.

Aims: Safari et al. seek to improve aortic valve repair by either aortic patching or valve sparing root replacement.

Late Durability of Mitral Repair for Ischemic Versus Nonischemic Functional Mitral Regurgitation.

Background: Concerns regarding long-term durability of surgical repair for functional mitral regurgitation are based on short-term data, with few comparisons of ischemic mitral regurgitation (IMR) versus nonischemic functional mitral regurgitation (NIFMR) etiology.

Methods: Consecutive patients (N = 788) receiving mitral repair for functional mitral regurgitation were evaluated from a prospectively maintained database. Patients with other surgical procedures were included.

Is redo mitral mortality getting better or getting worse?

Zubarevich et al. present the 30 day and 1-year outcomes of redo mitral valve replacement in 58 high-risk patients. The authors conclude that careful patient selection and risk stratification provides acceptable surgical results in this cohort.

Surgical risk scores: A roadmap to improved outcome?

Habertheuer et al. present a risk scoring system for predicting morbidity and mortality in 1181 patients undergoing surgery for drug associated endocarditis. The authors conclude that drug-related endocarditis is associated with significant morbidity and mortality and that an easily-applied risk stratification score may aid in clinical decision making.

Sustained results of robotic mitral repair in a lower volume center with extensive minimally invasive mitral repair experience.

The literature for robotic mitral repair is dominated by a small number of large volume institutions, and intermediate-term outcomes out to 5 years are rare. Whether and under what circumstances a lower volume institution could obtain durable outcomes is not known. A retrospective review was performed on all 133 patients undergoing robotically assisted mitral repair from 2011 to 2019 at a single institution.

Long-term outcomes of aortic root replacement for endocarditis.

Background: Infective endocarditis (IE) involving the aortic valve and root is associated with high risk requiring thoughtful surgical decision-making. The impact of valve and conduit choices and patient factors on long-term outcomes in this patient population is poorly documented.

Methods: From January 1976 to December 2013, 485 patients underwent aortic root and valve replacement at a single institution.