Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>The optimal treatment strategy following a failed mitral valve repair remains unclear. This study aims to compare and analyse available studies which report the clinical outcomes post mitral valve re-repair (MVr) or replacement (MVR) after a prior mitral valve repair.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Based on PRISMA guidelines, a literature search was performed utilising PubMed, Cochrane and Scopus databases to identify retrospective cohort studies that reported outcomes of MVr and MVR after a prior mitral valve repair. Data regarding operative mortality, clinical outcomes and complications were extracted, synthesized and meta-analysed where appropriate.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Eight studies with a total cohort of 1632 patients were used. After analysis, no significant differences in the short term and long-term operative mortality, incidence of stroke, congestive heart failure, Grade 1 and Grade 2 mitral regurgitation, requirement of 3rd mitral valve operation and reoperation due bleeding were found between the two groups. However, a slightly higher incidence of postoperative atrial fibrillation (OR: 0.11, CI: 0.02 to 0.17, I<jats:sup>2</jats:sup> = 0%, <jats:italic>p</jats:italic> = 0.02) was observed in the MVR group, as compared to the MVr group.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>MVr appears to be a viable alternative to MVR for mitral valve reoperation, given that they are associated with similar post-operative outcomes.</jats:p> </jats:sec>