{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T01:02:27Z","timestamp":1776560547800,"version":"3.51.2"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,6]]},"abstract":"<jats:sec id=\"jah38448-sec-0001\" sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">This study assessed risk factors for mitral regurgitation (MR) recurrence or functional mitral stenosis during long\u2010term follow\u2010up in patients undergoing mitral valve repair for isolated posterior mitral leaflet prolapse.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah38448-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We assessed a consecutive series of 511 patients who underwent primary mitral valve repair for isolated posterior leaflet prolapse between 2001 and 2021. Annuloplasty using a partial band was selected in 86.3%. The leaflet resection technique was used in 83.0%, whereas the chordal replacement without resection was used in 14.5%. Risk factors were analyzed for MR recurrence \u2265grade 2 or functional mitral stenosis with mean transmitral pressure gradient \u22655\u2009mm\u2009Hg using a multivariable Fine\u2013Gray regression model. The 1\u2010, 5\u2010, and 10\u2010year cumulative incidence of MR \u2265grade 2 was 7.8%, 22.7%, and 30.1%, respectively, whereas that of mean transmitral pressure gradient \u22655\u2009mm\u2009Hg was 8.1%, 20.6%, and 29.3%, respectively. Risk factors for MR \u2265grade 2 included chordal replacement without resection (hazard ratio [HR], 2.50,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001) and larger prosthesis size (HR, 1.13,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.023), whereas factors for functional mitral stenosis were use of a full ring (partial band versus full ring, HR, 0.53,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.013), smaller prosthesis size (HR, 0.74,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001), and larger body surface area (HR, 3.03,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.045). Both MR \u2265grade 2 and mean transmitral pressure gradient \u22655\u2009mm\u2009Hg at 1 year post surgery were significantly associated with the long\u2010term incidence of reoperation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah38448-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Leaflet resection with a large partial band may be an optimal strategy for isolated posterior mitral valve prolapse.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028607","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T09:31:09Z","timestamp":1685093469000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["What Is the Optimal Mitral Valve Repair for Isolated Posterior Leaflet Prolapse to Achieve Long\u2010Term Durability?"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3131-8882","authenticated-orcid":false,"given":"Takashi","family":"Kakuta","sequence":"first","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]},{"name":"Tohoku University Graduate School of Medicine","place":["Aoba\u2010ku, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9481-8860","authenticated-orcid":false,"given":"Satsuki","family":"Fukushima","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1659-9324","authenticated-orcid":false,"given":"Kimito","family":"Minami","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-4263","authenticated-orcid":false,"given":"Satoshi","family":"Kainuma","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naonori","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Tadokoro","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-9893","authenticated-orcid":false,"given":"Ayumi","family":"Ikuta","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Tonai","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0959-7133","authenticated-orcid":false,"given":"Yoshikatsu","family":"Saiki","sequence":"additional","affiliation":[{"name":"Tohoku University Graduate School of Medicine","place":["Aoba\u2010ku, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3023-5014","authenticated-orcid":false,"given":"Tomoyuki","family":"Fujita","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Research Center","place":["Suita, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)39144-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36733-9"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02047-6"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaa271"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-020-01317-2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14817"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.07.078"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2022.01.013"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000923"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.06.049"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-18-0751"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.10.033"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy062"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000699"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.08.006"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.12.022"},{"key":"e_1_3_2_18_2","first-page":"744","article-title":"Annuloplasty 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Annuloplasty ring size determines exercise\u2010induced mitral stenosis severity after valve repair. J. Heart Valve Dis. 2015;24:744\u2013751.","journal-title":"J. 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