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You are here: Contents > 2016 > Volume 25 Number 6 November 2016 > MITRAL VALVE DISEASE > Simple Interrupted Suturing for Redo Mitral Valve Replacement

Simple Interrupted Suturing for Redo Mitral Valve Replacement

Hiroshi Furukawa1,2, Taishi Tamura1, Takeshi Honda1, Hiroki Takiuchi1, Masahiko Kuinose1, Kazuo Tanemoto1

1Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan
2Electronic correspondence: hfurukawa@med.kawasaki-m.ac.jp

Background and aim of the study: An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR).

Methods: Among 336 mitral valve surgery patients at the authors’ institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three. The number of previous surgeries was one in 10 patients, two in seven, and three in four. With regards to surgical technique, sharp dissection was initially performed on one side of the previous prosthetic sewing cuff, and the overall sewing cuff was thereafter completely removed following leaflet detachment. SIS (mean number of sutures 32.5 ± 3.0; range: 28-40 sutures) was performed to implant the new

prosthesis, without exposing the rough surface of the previous mitral valve annulus, thereby allowing for eventual implantation of the same-sized or larger-sized prosthesis.

Results: The surgical procedure was successfully performed in all patients without any serious complications. Bioprostheses were selected for 11 patients, and mechanical valves for 10. Sixteen patients (76.2%) received a new prosthesis that was the same size as or larger than the previous prosthesis. Operative mortality within 30 days was 4.8%, which was similar to that of primary MVR in the same period (n = 83; 2.4%; p = 0.57). Recurrent PVL was detected in only one patient, who underwent a fourth surgery for SVD of the bioprosthesis.

Conclusion: SIS for redo MVR may allow for the implantation of larger prostheses, and this novel maneuver may achieve acceptable early clinical outcomes.

The Journal of Heart Valve Disease 2016;25:685-690

Simple Interrupted Suturing for Redo Mitral Valve Replacement

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