{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:37:32Z","timestamp":1785771452666,"version":"3.56.0"},"reference-count":75,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p xml:lang=\"en\">\n            Bioprosthetic mitral structural valve degeneration and failed mitral valve repair (MVr) have traditionally been treated with reoperative mitral valve surgery. Transcatheter mitral valve\u2010in\u2010valve (MVIV) and valve\u2010in\u2010ring (MVIR) replacement are now feasible, but data comparing these approaches are lacking. We sought to compare the outcomes of (1) reoperative mitral valve replacement (redo\u2010MVR) and MVIV for structural valve degeneration, and (2) reoperative mitral valve repair (redo\u2010MVr) or MVR and MVIR for failed MVr. A literature search of PubMed, Embase, and the Cochrane Library was conducted up to July 31, 2020. Thirty\u2010two studies involving 25\u00a0832 patients were included. Redo\u2010MVR was required in \u224835% of patients after index surgery at 10\u00a0years, with 5% to 15% 30\u2010day mortality. MVIV resulted in &gt;95% procedural success with 30\u2010day and 1\u2010year mortality of 0% to 8% and 11% to 16%, respectively. Recognized complications included left ventricular outflow tract obstruction (0%\u20136%), valve migration (0%\u20139%), and residual regurgitation (0%\u20136%). Comparisons of redo\u2010MVR and MVIV showed no statistically significant differences in mortality (11.3% versus 11.9% at 1\u00a0year,\n            <jats:italic>P<\/jats:italic>\n            =0.92), albeit higher rates of major bleeding and arrhythmias with redo\u2010MVR. MVIR resulted in 0% to 34% mortality at 1\u00a0year, whereas both redo\u2010MVr and MVR for failed repairs were performed with minimal mortality and durable long\u2010term results. MVIV is therefore a viable alternative to redo\u2010MVR for structural valve degeneration, whereas redo\u2010MVr or redo\u2010MVR is preferred for failed MVr given the suboptimal results with MVIR. However, not all patients will be candidates for MVIV\/MVIR because anatomical restrictions may preclude transcatheter options from adequately addressing the underlying pathology.\n          <\/jats:p>","DOI":"10.1161\/jaha.120.019854","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T10:19:42Z","timestamp":1615285182000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Reoperative Mitral Surgery Versus Transcatheter Mitral Valve Replacement: A Systematic Review"],"prefix":"10.1161","volume":"10","author":[{"given":"Aditya","family":"Sengupta","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Mount Sinai Hospital New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhang","family":"Yazdchi","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1012-7967","authenticated-orcid":false,"given":"Sophia L.","family":"Alexis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Mount Sinai Hospital New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Percy","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Premkumar","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Hirji","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinayak N.","family":"Bapat","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Heart &amp; Vascular CenterHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6500-7471","authenticated-orcid":false,"given":"Tsuyoshi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Brigham and Women's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7219-990X","authenticated-orcid":false,"given":"Gilbert H. 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