biostudies-literatureUnknown40(8)Agnino AUniversity Hospital of Reims<h4>Objectives</h4>Repairing severe mitral regurgitation (MR) in patients with degenerative bileaflet prolapse and reduced left ventricular ejection fraction (LVrEF) is challenging. The Free Margin Running Suture (FMRS) technique offers a non-resectional approach, but mid-term data are limited.<h4>Methods</h4>We analysed 28 patients with bileaflet degenerative MR and LVrEF (≤40%) undergoing FMRS. Primary outcomes were mid-term survival and MR recurrence; secondary outcomes included LVEF, in-hospital complications, transmitral gradient, coaptation length, and mitral valve orifice area.<h4>Results</h4>Mean age was 59.3 ± 12.8 years; 69.4% were male. No perioperative deaths; 1 patient required ECMO. Mean aortic cross-clamp time was 47 ± 18.6 min. Over 4.7 years, survival was 100%, with 1 case of moderate MR recurrence. At follow-up, LVEF improved to 43.04 ± 2.26 (P < 0.001), and all patients were NYHA I-II.<h4>Conclusions</h4>FMRS is a minimally invasive, reproducible technique providing durable repair, symptomatic improvement, and excellent mid-term survival.Interdisciplinary cardiovascular and thoracic surgeryivaf187https://www.ebi.ac.uk/biostudies/studies/S-EPMC12371330biostudies-literatureFree Margin Running Suture Repair for Bileaflet Mitral Valve Prolapse in Patients with Left Ventricular Dysfunction: A Mid-term Follow-up Study.PMC12371330Muccio SAnselmi ARuggieri VGD'Errico Ramirez AAgnino AParrinello MfalseFree Margin Running Suture Repair for Bileaflet Mitral Valve Prolapse in Patients with Left Ventricular Dysfunction: A Mid-term Follow-up Study.<h4>Objectives</h4>Repairing severe mitral regurgitation (MR) in patients with degenerative bileaflet prolapse and reduced left ventricular ejection fraction (LVrEF) is challenging. The Free Margin Running Suture (FMRS) technique offers a non-resectional approach, but mid-term data are limited.<h4>Methods</h4>We analysed 28 patients with bileaflet degenerative MR and LVrEF (≤40%) undergoing FMRS. Primary outcomes were mid-term survival and MR recurrence; secondary outcomes included LVEF, in-hospital complications, transmitral gradient, coaptation length, and mitral valve orifice area.<h4>Results</h4>Mean age was 59.3 ± 12.8 years; 69.4% were male. No perioperative deaths; 1 patient required ECMO. Mean aortic cross-clamp time was 47 ± 18.6 min. Over 4.7 years, survival was 100%, with 1 case of moderate MR recurrence. At follow-up, LVEF improved to 43.04 ± 2.26 (P < 0.001), and all patients were NYHA I-II.<h4>Conclusions</h4>FMRS is a minimally invasive, reproducible technique providing durable repair, symptomatic improvement, and excellent mid-term survival.2025-01-01T00:00:00Z2025 Aug2026-05-09T10:46:20.613Z2026-04-08T00:48:44.928ZS-EPMC123713304079578110.1093/icvts/ivaf187