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Long-term results of mitral valve repair.

(1) Carpentier techniques of repair are the dominant method today because of durability and reproducible results. (2) Mitral valve repair results in high survival, low risk of anticoagulant-related complications, and low risk of infective endocarditis. (3) Long-term anticoagulation is avoided in approximately half of the patients; yet, over the long term, thromboembolism occurs significantly less with repair than with valve replacement. (4) The rate of reoperation after mitral valve repair is not significantly different from that of mechanical valve replacement up to 10 postoperative years. (5) Mitral valve repair for degenerative mitral regurgitation results in a higher freedom from reoperation at 5 years and beyond, compared with rheumatic causes of regurgitation. (6) Ischemic and congenital etiologies for mitral regurgitation demand repair whenever feasible. Results in these patient groups favor repair over other options.