Evaluation of Early and Midterm Mitral Valve Repair Results in Consecutive Severe Mitral Regurgitation Patients
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Keywords
Mitral Valve Repair, Regurgitation, Repair Techniques
Abstract
Study Objectives: Surgical valve repair for mitral regurgitation has significant advantages over valve replacement. In this study, we aimed to investigate the early and mid-term results of mitral valve repair using current techniques in order to find out independent risk factors affecting the early and mid-term outcomes. Methods: We retrospectively studied firstly 192 consecutive adult patients (mean age: 43.2±12.3; 120 females and 72 males) who underwent primary mitral valve repair between January 2012 and July 2018. Risk factors affecting the need for re-operations and late survival were determined via univariate and multivariate analyses. Actuarial survival and event-free curves were compared by linear regression analysis. Results: Operative mortality was 2.6% (5 deaths 0–30th. postoperative day (POD). Late mortality was 3.7% (7/187). Reoperation was required in 16 (8.3%) patients. Kaplan–Meier actuarial survival was 95.8%±2.3% at a mean of 43 months. Survival free from reoperation was 92.8%± 4.2% at 60 months. Multivariate analysis demonstrated that residual NYHA class III and IV, low preoperative ejection fraction, and ischemic MR were independent predictors of mortality. Conclusion: We concluded that mitral valve repair showed excellent survival (except ischemic MR), acceptable re-operation rate with satisfactory valve function in a mid-term follow-up period.
References
2-Gillinov AM, Cosgrove DM, Blackstone EH, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg 1998;116:734-43
3-Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AL, Bailey KR, Frye RL. Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. Circulation 1995;91:1022-8
4-Suri RM, Schaff HV, Dearrani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg 2006;82:819-26
5-Gillinov AM, Wierup PN, Blackstone EH, et al. Is repair preferable to replacement for ischemic mitral regurgitation? J Thorac Cardiovasc Surg 2001;122:1125-41
6-Vetter HO, Burack JH, Factor SM, et al. Replacement of chordae tendineae of the mitral valve using the new expanded PTFE suture in sheep. In: Bodnar E, Yacoub M, eds. Biologic bioprosthetic valves. New York:Yorke Medical Books, 1986:772-84.
7-Seeburger J, Kuntze T, Mohr FW. Gore-Tex chordoplasty in degenerative mitral valve repair. Semin Thorac Cardiovasc Surg 2007;19:111-8.
8-Savage EB, Ferguson TB Jr, DiSesa VJ. Use of mitral valve repair: analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg 2003;75:820-5
9-Gogbashian A, Sepic J, Soltesz EG, Nascimben L, Cohn LH. Operative and long-term survival of elderly is significantly improved by mitral valve repair. Am Heart J 2006;151:1325-33
10- Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81
11-Ailwadi G, Swenson BR, Girotti ME, et al. Is mitral valve repair superior to replacement in elderly patients? Ann Thorac Surg 2008;86:77-86
12- Gilinov AM, Blackstone EH, Nowicki ER, et al. Valve repair versus valve replacement for degenerative mitral valve disease. J Thorac Cardiovasc Surg 2008;135:885-93.
13-Habib G, Thuny F, Avierinos JF. Prosthetic valve endocarditis: current approach and therapeutic options. Prog Cardiovasc Dis 2008;50:274-81
14-Gazoni LM, Kern JA, Swenson BR, et al. A change in perspective: results for ischemic mitral valve repair are similar to mitral valve repair for degenerative disease. Ann Thorac Surg 2007;84:750-7
15-Thourani VH, Weintraub WS, Guyton RA, et al. Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. Circulation 2003;108:298-304
16- Nagendran J, Norris C, Maitland A, Koshal A, Ross DB. Is mitral valve surgery safe in ocrogenarians? Eur J Cardiothorac Surg 2005;28:83-7
17-Deloche A, Jebara VA, Relland JYM, et al. Valve repair with Carpentier techniques. The second decade. J Thorac Cardiovasc Surg 1990; 99: 990-1002.
18-Lessana A, Viet TT, Ades F, et al. Mitral reconstructive operations. A series of 130 consecutive cases. J Thorac Cardiovasc Surg 1983; 86: 553-61
19-Cosgrove DM 3rd, Arcidi JM, Rodriquez L, Stewart WJ, Powell K, Thomas JD. Initial experience with the Cosgrove-Edwards Annuloplasty System Ann Thorac Cardiovasc Surg 1995;60:499-504
20-Gillinov AM, Cosgrove DM, Lytle BW, et al. Reoperation for failure of mitral valve repair. J Thorac Cardiovasc Surg 1997; 113: 467-75.
21-Orszulak TA, Schaff HV, Danielson GK, et al. Mitral regurgitation due to ruptured chordae tendineae. Early and late results of valve repair. J Thorac Cardiovasc Surg 1985; 89: 491-8.
22-Schravone WA, Cosgrove DM, Lever HM, Stewart WJ, Salcedo EE. Long-term follow-up of patients with left ventricular outflow tract obstruction after Carpentier ring mitral valvuloplasty. Circulation 1988;78:160-5
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