Factors associated with recurrence of mitral regurgitation 14 days after rheumatic mitral valve repair

Background Rheumatic mitral valve repair has been subject to clinical scrutiny due to the recurrence of postoperative regurgitation. This study aimed to identify factors associated with the development of mild or greater mitral regurgitation (MR) within 14 days after surgical repair. Methods A total of 164 patients (mean age 44.73 years, 36 males) diagnosed with rheumatic mitral valve disease who underwent open-chest mitral valve repair at Shanghai Fourth People's Hospital, Tongji University School of Medicine, between March 17, 2023 and December 15, 2025, were enrolled. Mild MR was diagnosed using a comprehensive echocardiographic assessment, incorporating quantitative and semi-quantitative Doppler parameters—including color jet area (CJA) in the apical four-chamber view and vena contracta width (VCW), and the subjects were grouped accordingly. Results A total of 164 patients were enrolled. Baseline clinical characteristics were well balanced between the two groups (all P > 0.05). At the 14-day postoperative time point, logistic regression analysis comparing the two groups revealed that preoperative CJA was significantly associated with non-minimal MR ( P < 0.05) after adjustment for intraoperative concurrent stripping of thickened leaflets. However, this association became non-significant ( P > 0.05) following additional adjustment for preoperative mitral valve orifice area (MVOA). Pearson correlation analysis revealed statistically significant associations between preoperative CJA and preoperative MVOA and between preoperative CJA and concurrent stripping of thickened leaflets ( P < 0.05); variance inflation factor (VIF) values for both pairs were below 5 (VIF < 5), indicating absence of multicollinearity. Conclusion Preoperative CJA may serve as a valuable adjunctive parameter for perioperative risk stratification and individualized surgical planning in rheumatic mitral valve repair surgery.