skip to main content

Post-MV Repair Surveillance — EECC MCQ

Instant feedback + full explanation. One question, done properly.

EasyValvular Heart DiseasePost-MV Repair SurveillanceEECC

A 60-year-old man with severe chronic primary MR (flail P2 segment) undergoes successful MV repair with a ring annuloplasty and P2 resection. Post-operative TOE shows trivial MR with good coaptation. What long-term follow-up is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Echocardiographic surveillance at 1 year, then every 2-3 years if stable — monitoring for late recurrence of MR, LV function, and annuloplasty ring-related complications; lifelong follow-up is recommended as repair durability is not unlimited

After successful MV repair, long-term surveillance is essential. The 2025 ESC VHD Guidelines recommend: (1) baseline post-operative TTE before discharge (confirm repair result); (2) TTE at 1 year; (3) then every 2-3 years if stable (more frequently if any concern). Monitoring for: (1) recurrent MR (occurs in ~5-10% by 10 years for posterior leaflet repair; higher for anterior/bileaflet repair); (2) LV function (LVEF should improve or stabilise post-repair — decline may indicate recurrent MR or underlying myocardial disease); (3) ring complications (dehiscence, endocarditis, haemolysis — all rare); (4) SAM/LVOT obstruction (if excess anterior leaflet tissue); (5) pulmonary artery pressure; (6) AF development. Anticoagulation: warfarin for 3 months post-repair (while the ring endothelialises), then aspirin; if AF present, long-term OAC. Endocarditis prophylaxis for repaired valves with prosthetic material is recommended.

Reference: ESC/EACTS (2025): VHD Guidelines