Free Margin Running Suture Repair for Bileaflet Mitral Valve Prolapse in Patients with Left Ventricular Dysfunction: A Mid-term Follow-up Study.

OBJECTIVES

Repairing severe mitral regurgitation (MR) in patients with degenerative bileaflet prolapse and reduced left ventricular ejection fraction (LVrEF) is challenging. The Free Margin Running Suture (FMRS) technique offers a non-resectional approach, but mid-term data are limited.

METHODS

We analysed 28 patients with bileaflet degenerative MR and LVrEF (≤40%) undergoing FMRS. Primary outcomes were mid-term survival and MR recurrence; secondary outcomes included LVEF, in-hospital complications, transmitral gradient, coaptation length, and mitral valve orifice area.

RESULTS

Mean age was 59.3 ± 12.8 years; 69.4% were male. No perioperative deaths; 1 patient required ECMO. Mean aortic cross-clamp time was 47 ± 18.6 min. Over 4.7 years, survival was 100%, with 1 case of moderate MR recurrence. At follow-up, LVEF improved to 43.04 ± 2.26 (P < 0.001), and all patients were NYHA I-II.

CONCLUSIONS

FMRS is a minimally invasive, reproducible technique providing durable repair, symptomatic improvement, and excellent mid-term survival.