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Page 14 of 20  Nappi et al. Vessel Plus 2021;5:40  https://dx.doi.org/10.20517/2574-1209.2021.06


 Table 3. Baseline characteristics of all patients in surgical approach groups [36-44]

 r-MVR   r-MVr   Age, y,       STS       NYHA Class III or  LVEF (%; mean ±  Heart
 Overall Sternotomy Thoracotomy
 (%)  (%)       median         score     IV                 SD)                failure

 4 institutions within the Northwell Healt System  256  166  90  145 (56.6)  111 (43.4)  62.2 ± 14.7  8.1 ± 0.09 93 (56)  52.9 ± 12.6
 Single Surgical Team (autors ACA and DHA)  53  44  9  45 (84.9)  8 (15.1)  57 ± 13.2  34 (64)  54.3 ± 10.8
 Division of Cardiac Surgery of Maryland School of   130  130  0  41 (31)  39 (30)  62 ± 15  96 (74)  51 ± 12
 Medicine
 Mayo Clinic Rochester  145  N.I.  N.I.  81 (56%)  64 (44)  69 (47,5)  (n = 136)

 Re-repair  64  64 ± 13                                     57 ± 12
 Replacement  81  67 ± 11                                   56 ± 11

 Michigan Medical Centre  450  0  450    NYHA Class
 Fibrillatory Arrest  134  0  134  55 (41.1)  79 (58.9)  63 ± 13  2.7 ± 0.8  36 ± 13

 Beating heart  316  0  316  101 (33)  215 (67)  63 ± 15  2.6 ± 0.7  38 ± 9
 Pennsylvania Health System  305  249  56  257  48          LVEF < 40% (%)

 Re-repair      61 ± 16                  N.I.               10 (19)
 Replacement    62 ± 15                  N.I.               38 (15)
 Medicare Provider Analysis and Review  1627  815  812  74                     1275

 Re-repair  285
 Replacement  1332

 A 10-year single-centre experience  49  49  63 ± 13
 Division of Cardiovascular Surgery, Toronto General   513  57 ± 13  227 (44)  < 40% (15%)
 Hospital


 STS: Society of Thoracic Surgeons; NYHA: New York Heart Association; LVEF: left ventricle ejection fraction; r-MVR: redo mitral valve replacement; r-MVr: redo mitral valve repair; N.I.: not indicated.



 Regarding TMViV-T, the following is fundamental. First, the evaluation of clinically relevant endpoints should reflect the safety and efficacy of MRI
 treatments. Second, consistent clinical definitions for these endpoints should be used across the relevant studies. The use of TMViV-T as mechanical

 intervention is aimed to change the extent of the survival benefit. In contrast, the evidence on the use of a standard surgical approach has consistently shown
 favorable results, and this option has gained the support of the surgical community.
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