ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2024
Long-term results of edge-to-edge and neochordal mitral repair for isolated anterior leaflet lesion: a propensity match analysis.
Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- From Bailout to Benchmark? Rethinking the Alfieri Procedure for Mitral Regurgitation in Barlow's Disease.Journal of clinical medicine · 2026Article
- Primary mitral regurgitation, surgery in the transcatheter era: when the neighbourhood becomes noisy: a state-of-art review.European heart journal. Imaging methods and practice · 2025Review
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13 authors.
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Abstract
objectivesMitral regurgitation due to anterior mitral leaflet lesions is associated with an increased risk of mitral regurgitation recurrence after mitral valve repair compared with posterior leaflet-related lesions. Both edge-to-edge (E-to-E) and neochordal repair, associated with ring annuloplasty, have been used in our institution to address isolated anterior mitral leaflet lesions. The aim of this study was to compare the clinical and echocardiographic long-term results of those two approaches for isolated anterior mitral leaflet lesions by means of a propensity match analysis.
methodsAn institutional database retrospective review within the time-frame 2000 to 2021 was carried out. The Kaplan-Meier method and cumulative incidence function were employed. Cox regression was used to identify the risk factor for mortality during the follow-up.
resultsThe estimated freedom from reoperative mitral valve surgery at 20 years was 78% in the E-to-E group and 64% in the neochordae group (P = 0.032). The longitudinal analysis performed to analyse the mitral regurgitation recurrence rate showed a higher rate of mitral regurgitation ≥3+ recurrence in the neochordae group at 5 (5.1% vs 8.7%), -10 (8.2% vs 13.2%), and 15 years (8.8% vs 16.5%) (P < 0.001).
conclusionsIsolated anterior leaflet pathology can be effectively treated with E-to-E or neochordal repair and ring annuloplasty. In our series, clinical and echocardiographic results were better in E-to-E group. The excellent durability of this technique up to 20 years of follow-up, together with its simplicity and reproducibility, confirms the role the E-to-E techniques as an excellent treatment option for severe mitral regurgitation due anterior mitral leaflets lesions.
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