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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.