When adjusted for anterior MV leaflet repair, postrepair MV gradient was associated with a higher risk of MV reintervention (HR 1.378, 95% CI 1.033–1.838; P = 0.029; Supplementary material, Table S1). A total of 11 late reinterventions were performed. The indication for reintervention was recurrent MR in 9 patients and elevated MV gradient in the remaining 2 patients. In both of the latter patients, a postrepair gradient of ≥5 mmHg (5.88 and 5.23 mmHg, respectively) was seen on predischarge echocardiography, despite an acceptable gradient seen on intraoperative echocardiography (2.53 and 4.23 mmHg, respectively). In the first of the latter patients, an annuloplasty ring size 26 was initially implanted and a re-repair due to heart failure symptoms (no significant MR or other explanation for this observation were found) was performed 1.3 years after the initial operation. Upon reoperation, the annuloplasty ring was explanted, resolving the problem of elevated gradient. In the other patient, an annuloplasty ring size 32 was implanted during the initial operation. Severe pannus formation occurred and the patient underwent a valve replacement 1.1 years after the initial operation.