Ozeki T; Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
Ito T; Hosoba S; Shintani A; Orii M; Tokoro M; Shimizu S; Sawaki
S; Usui A; Mutsuga M

General Thoracic & Cardiovascular Surgery. 74(4):369-375, 2026 Apr.

OBJECTIVES: Few physiological assessments are available for patients who
undergo mitral valve repair for severe mitral regurgitation (symptomatic
or asymptomatic). The aim of the study was to evaluate change in exercise
tolerance as a means of physiological assessment following mitral valve
repair.

METHODS: We studied 41 consecutive patients who received elective
isolated mitral valve repair for severe mitral regurgitation in a
minimally invasive manner via a completely endoscopic platform and who
underwent cardiopulmonary exercise testing in our institution between
February 2018 and August 2019. There were 21 asymptomatic (group A) and 20
symptomatic (group S) patients. Physiological assessment was performed by
cycle ergometer cardiopulmonary exercise testing pre-operatively and at
approximately 6 months post-operatively.

RESULTS: Mean age was 59 +/- 11.6 years and 24 patients were male
(58.5%). Overall, there was no significant change in peak oxygen
consumption or anaerobic threshold after surgical repair. There were no
intergroup differences in terms of peak oxygen consumption, anaerobic
threshold, ventilation/carbon dioxide production, or gas exchange ratio.
There were no intergroup differences in any transthoracic
echocardiographic variable except for post-operative left atrial dimension
(group A: 35.2 +/- 5.9 vs. group S: 39.8 +/- 6.2, p = 0.01).

CONCLUSIONS: There was no statistically discernible change in functional
capacity at 6-12 months after endoscopic mitral valve repair. The
physiological assessment found no improvements in cardiopulmonary exercise
testing values post-operatively despite improvement of the symptoms.