†These authors contributed equally.
Academic Editors: Takeshi Kitai and Yukikatsu Okada
Background: Treatment of moderate functional mitral regurgitation (FMR)
during aortic valve replacement (AVR) is controversial. This study aimed to
evaluate the effect of different surgical strategies in patients with moderate
FMR undergoing AVR. Methods: A total of 468 patients with moderate FMR
undergoing AVR from January 2010 to December 2019 were retrospectively studied
comparing 3 different surgical strategies, namely isolated AVR, AVR + mitral
valve repair (MVr) and AVR + mitral valve replacement (MVR). Survival was
estimated using the Kaplan-Meier method and compared with the log-rank test,
followed by inverse probability treatment weighting (IPTW) analysis to adjust the
between-group imbalances. The primary outcome was overall mortality.
Results: Patients underwent isolated AVR (35.3%), AVR + MVr (30.3%),
or AVR + MVR (34.4%). The median follow-up was 27.1 months. AVR + MVR was
associated with better improvement of FMR during the early and follow-up period
compared to isolated AVR and AVR + MVr (p