RE-REPAIR AFTER PREVIOUS MITRAL VALVE SURGERY

Background and Aim: Evidences in the literature show that close to 20%of patients undergoing primary mitral valve (MV) surgery require reoperation on long-term follow-up, and significant proportion of this patients received a conservative operation. Aim of this study is to analyze outcome of patients undergoing a second MV repair operation. Methods: Patients who underwent redo MV repair between 2012 and 2024 were retrospectively analysed. Primary outcomes were mortality and freedom from MV reoperation at 30 days. Results: Twenty-seven patients were included. Mean age was 63 years and 20 (74%) were men. Progressive mitral valve degeneration was the most common cause of previous repair failure (88%). Median time to reoperation was 4,5 years. Re-repair was most commonly performed through a minimally invasive approach (81%) with the endo-aortic clamp (63%). MV annuloplasty was performed in the 70% of the cases, and artificial chords were implanted in the 59% of the cases. Re-exploration for bleeding, stroke, and acute renal dysfunction were reported in 1, 2, and 2 cases respectively. Thirty-day mortality was reported in 1 case, while 3 patients required a reoperations in the follow-up period. Conclusions: The emergence of MV repair as the preferred treatment for severe mitral regurgitation caused by degenerative disease has been accompanied by an increasing number of valve repair failures seen by surgeons. This report shows that MV re-repair is feasible and effective in high volume, high experienced centers in MV surgery.