Early And Long-term Echocardiographic Assessment Following Minimally Invasive Mitral Valve Repair
Witold Gerber1, Krzysztof Sanetra1, Agnieszka Drzewiecka- Gerber1, Justyna Jankowska- Sanetra2, Andrzej Bochenek1, Krzysztof Białek1, Marek Cisowski1.
11st Department of Cardiac Surgery, American Heart of Poland, Bielsko- Biała, Poland, 22nd Department of Cardiology, American Heart of Poland, Bielsko-Biała, Poland.
Objectives: To determine whether patients with severe mitral regurgitation undergo significant reverse remodelling after minimally invasive mitral valve repair
Methods: Consecutive patients who underwent mitral valve repair due to severe mitral regurgitation were assessed in clinical and echocardiographic long-term follow-up. The analysed echocardiographic parameters included: EF- ejection fraction; EDV- end-diastolic volume; ESV- end systolic volume; EDD end diastolic diameter; ESD- end systolic diameter; LA Area- left atrial area, LA volume- left atrial volume; RA volume- right atrial volume. The echocardiography was performed before the surgery, in the 1st, 6th, 12th and 24th month after the surgery.
Results: A group of 145 patients was included in the report. Throughout the clinical observation, one death (0.7%), two reoperations (1.4%) and no stroke or myocardial infarction were noted. The statistical difference (baseline vs 1st month vs 6 month vs 12th month vs 24th month) was visible in median EF (68% vs 57% vs 60% vs 60% vs 61%; p<0.000001), EDV (165cm3 vs 109 cm3 vs 104 cm3 vs 100 cm3 vs 109 cm3; p <0.000001), ESV (51cm3 vs 46 cm3 vs 42 cm3 vs 40 cm3 vs 42 cm3; p= 0.000781), EDD (58 mm vs 50 mm vs 50 mm vs 49 mm vs 49 mm; p<0.000001), ESD (35 mm vs 33 mm vs 32 mm vs 30 mm vs 30mm; p=0.000044), LA area (26 cm2 vs 19 cm2 vs 18 cm2 vs 18 cm2 vs 18 cm2; p<0.000001) and LA volume (96 cm3 vs 60 cm3 vs 54 cm3 vs 54 cm3 vs 49 cm3; p<0.000001). No statistical difference was shown in median RA area (15 cm2 vs 15 cm2 vs 14 cm2 vs 14 cm2 vs 13 cm2; p= 0.063158).
Conclusions: Minimally invasive mitral valve repair is an efficient method of treatment for severe mitral regurgitation. Reverse remodelling of left ventricle and left atrium is visible in the first moth following surgery and remains stable.
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