Background Mitral valve repair (MVRe) is considered to have a superior outcome compared to replacement (MVRp) in patients with mitral valve regurgitation (MVR). It was the aim of the study to analyse the clinical results and identify risk factors for short and long-term mortality. Methods In a retrospective single-center analysis, patients undergoing an isolated mitral valve procedure from June 2010 to December 2016 were identified. These were subsequently homogenized using 10 baseline characteristics for propensity-score matching. Comparative analyses were performed for early and long-term results, using adequate statistical tools, and identifying risk factors for the investigated endpoints, primary end-point: all-cause mortality within 5 years and secondary end-points: recurrent MVR, reoperation, endocarditis and/or mortality with 30 days, 1, 3 and 5 years. Results 241 patients were identified in the entire patient cohort. After matching, patients were divided into 2 groups of 64 each respectively. The median age was similar in the two groups. There was a significant interaction between early mortality risk of MV in patients with coronary artery disease (CAD) (OR 11.94, 95% CI 1.49–285.92, p = 0.04) and late mortality in patients with higher EuroSCORE II (HR 1.14, 95% CI 1.06–1.23, p < 0.001). The primary end-point showed 5-year survival rate was significantly higher in MVRe versus MVRp (90.06% vs. 79.54% respectively, p = 0.04). The secondary end-point demonstrated recurrent MVR not to be statistically significant between the 2 groups (p = 0.09) as well as reoperation (p = 0.28). Endocarditis was observed in one patient after MVRp. Conclusions We concluded MVRe to be associated with lower operative and 5-year mortality and good postoperative outcomes compared to patients undergoing MVRp. Concomitant CAD was identified as one of the risk factors for increasing the in-hospital mortality rate. There was no significant difference in rehospitalisation over the follow-up period. MVRe should be the treatment of choice for severe MVR and should remain a central aspect in valve centers' treatment algorithms and quality measures.

Endovascular stent placement for chronic postthrombotic iliofemoral venous obstructive lesions is an effective therapeutic option and might be complicated by stent migration. We report a case of a venous stent that was lost from the iliac vein into the right ventricle rescued by emergent open-heart surgery.

Ring dehiscence is a serious complication after mitral valve annuloplasty, tending to occur primarily from the posterior annulus. The tension on the ring sutures during the cardiac cycle is one of the suspected reasons; in order to minimize this tension, we apply four additional pledgeted sutures positioned supra-annularly at critical hinge points and could achieve a marked reduction of annular dehiscence since.

Background: Mitral valve repair (MVRe) is considered to have a superior outcome compared to replacement (MVRp) in patients with mitral valve regurgitation (MVR). It was the aim of the study to analyze the clinical results and identify risk factors for short and long-term mortality. Methods: In a single-center analysis, patients undergoing isolated mitral valve procedures from June 2010 to December 2016 were identified. These were subsequently homogenized using 10 baseline characteristics for propensity-score matching. Comparative analyses were performed for early and long-term results, using the adequate statistical tool, identifying risk factors for the investigated endpoints. Results: 241 patients were identified in the entire cohort. After matching, patients were divided into 2 groups of 64 in each. The median age was similar. There was significant interaction to early mortality risk of MV in patients with coronary artery disease (CAD) (OR 11.94, 95% CI: 1.49-285.92, P=0.04) and late mortality in patients with higher EuroSCORE II (HR 1.14, 95% CI: 1.06-1.23, P<0.001). 5-year survival was significantly higher in MVRe versus MVRp (90.06% vs. 79.54% respectively, P=0.04). Conclusions: We concluded MVRe to be associated with lower operative and 5-year mortality and good postoperative outcomes compared to patients undergoing MVRp. Concomitant CAD was identified as one of the risk factors for increasing the in-hospital mortality rate. There was no significant difference in rehospitalization over the follow-up period. MVRe should be the treatment of choice for severe MVR and should remain a central aspect in valve centers’ treatment algorithms and quality measures.