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OBJECTIVE: We evaluated the safety and durability of a transaortic edge-to-edge mitral valve repair in patients undergoing minimally invasive aortic valve replacement
METHODS:
We retrospectively analyzed all patients who underwent concomitant aortic valve replacement and transaortic edge-to-edge mitral valve repair via a right mini-thoracotomy (minimally invasive) at our institution between September 2008 and September 2011. Intra-operative transesophageal, and follow-up transthoracic echocardiograms were performed to evaluate the adequacy of the repair, and assess for any post-operative recurrence of mitral regurgitation (MR).
RESULTS: There were 24 patients identified (16 males and 8 females), with 8 patients having a history of prior heart surgery. The median EuroSCORE was 12.5 (IQR 6-23). The mitral valve lesion was classified as functional (n=11), degenerative calcification (n=10), or rheumatic (n=3). The median aortic cross clamp and cardiopulmonary bypass times were 101 minutes (IQR 86-116) and 127 minutes (IQR 109-149), respectively. There was one (4%) in-hospital death. The median total hospital length of stay was 8 days (IQR 7-12). Median pre-operative versus post-operative MR grade was 3 (IQR 3-4) versus 0 (IQR 0-1), P<0.001. Median time to follow-up echocardiogram was 13 days (IQR 5-93). Median preoperative versus follow-up MR grade was 3 (IQR 3-4) versus 1 (IQR 0-2), P<0.001, and postoperative versus follow-up MR was 0 (IQR 0-1) versus 1 (IQR 0-2), P=0.01, respectively.
CONCLUSIONS: : In patients undergoing minimally invasive aortic valve replacement with at least moderate mitral valve regurgitation, a transaortic edge-to-edge mitral valve repair is a safe and effective alternative to conventional double valve surgery