Mitral repair of myxomatous valves with simple annuloplasty: a follow-up up to 12 years

Objectives: Diffuse myxomatous mitral valve degeneration represents a challenge in the reparative mitral valve surgery. A subgroup of patients with symmetrical diffuse myxomatous mitral valve degeneration can be effectively treated with a simple band-annuloplasty with good early and mid-term results. Here we evaluate the long-term outcomes in terms of freedom from reoperation, recurrence of moderate or severe mitral regurgitation and overall survival. Methods: Between April 2006 and December 2020, patients with diffuse myxomatous mitral valve degeneration causing severe mitral regurgitation and the echocardiographic features of symmetrical bileaflet prolapse, central regurgitant jet(s), anular dilation, no chordal ruptures, were treated using a simple annuloplasty with a semi-rigid band. These patients were prospectively collected and retrospectively analyzed. Results: Seventy-five patients were enrolled. Mean clinical follow-up time was 104 (SD: 43) months, echocardiographic follow-up time was 95 (SD: 43) months. The mean age was 54 (SD : 15) years, 56% were females. Long-term overall survival was 98.2% (SE: 1.8), 93.7% (SE: 4.7) and 93.7% (SE: 4.7) at 4, 8, 12 years respectively. The freedom from reoperation was 100% at 4 and 8 years and 94.1% (SE: 5.7) at 12 years. The freedom from recurrent moderate or severe mitral regurgitation was 98.3% (SE: 1.7), 98.3% (SE: 1.7), 92.8% (SE: 5.5) at 4, 8, 12 years respectively. Conclusions: Mitral repair with the simple band-annuloplasty for the treatment of mitral regurgitation due to symmetrical diffuse myxomatous mitral valve degeneration seems to be stable and effective in the long term. Clinical registration number: 2022-06.