Midterm Outcome of Mitral Valve Repair in 351 Patients From A Single Team in Turkey
Kerim Cagli1, Ersin Kadirogullari1, Omer Faruk Cicek1, Emre Yasar1, Serkan Mola1, Ibrahim Erkengel1, Eren Gunertem1, Ferhat Ikbaliafsar1, Sabit Kocabeyoglu1, Ali Baran Budak2, Adnan Yalcinkaya1, Adem Diken3, Gokhan Lafci1, Serdar Gunaydin2.
1Yuksek Ihtisas Training & Research Hospital, Ankara, Turkey, 2Numune Training & Research Hospital, Ankara, Turkey, 3Hitit University, School of Medicine, Corum, Turkey.
OBJECTIVE: Mitral valve repair is feasible for all patients with mitral regurgitation (MR) and/or stenosis (MS) and its advantages are well documented; however, there is general agreement that it is technically demanding and that success rates are related to volume/ experience of the centers. The aim of this study was to evaluate the clinical and echocardiographic outcome of patients who underwent mitral repair by a single team.
METHODS: We retrospectively evaluated 351 patients underwent mitral valve repair for MR and/or MS during the period from May 2009 until December 2013. 192 patients were male (54,7%) and mean age was 50.8±16.5. 222 patients (63.3%) had degenerative disease, 71 (20.2%) had congenital, 26 (7.4%) ischemic and 32 (9.1%) had rheumatic origin. 7 patients (2%) had prior valve surgery and recurrent regurgitation. The mean EuroSCORE was 8.2±2.4 and 2/3 of the patients were in NYHA class III/IV. Repair procedures included mitral ring annuloplasty, quadrangular resection, chordal replacement and commissuroplasty.
RESULTS: According to control postoperative echocardiography (mean 23.4±17.2 months), 309 patients (88%) had no MR. 4(1,1%) patients underwent valve replacement intraoperatively due to lack of coaptation after repair. Short-term (<30 days) mortality was 2% and long-term mortality was 2.6%. 8 patients (2,4%) had trivial MR and 7 (2,1%) of them are still under follow-up. 7(2%) patients had severe MR and underwent second surgery. Mechanical valve replacement was preferred in 6(1,7%) and valve repair was performed in 1(0,3%) of them. Postoperative complications included atrial fibrillation 15.4%, check bleeding 3.1% and wound infection 1.6%.
CONCLUSIONS: Mitral valve repair techniques should be considered at first place in surgical treatment of mitral valve disease when it’s possible and can be used as a safe and an effective choice with its superiority to mechanical valve replacement in experienced centers.
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