Sameh Sayed1,2,3, Veronica Gebhardt1, Dejan Radakovic1, Armin Gorski1, Rainer Leyh1, Ivan Aleksic11Department of Cardiothoracic Surgery, Julius-Maximilians University, Würzburg, Germany
2Department of Cardiothoracic Surgery, Assiut University, Egypt
3Elextronic correspondence: e-mail: email@example.com
Background and aim of the study: Mitral valve repair techniques using artificial chordae (expanded polytetrafluorethylene sutures) and complete leaflet preservation have been widely employed to treat mitral prolapse. The study aim was to evaluate early and mid-term outcomes after repair of prolapsed degenerative mitral valve leaflets, using this approach.
Methods: Between 2010 and 2014, at the authors’ institution, a total of 209 patients (55 females, 154 males; mean age 62.0 ± 12.5 years) underwent mitral valve repair using the defined approach. Posterior leaflet prolapse was observed in 119 patients, anterior prolapse in 55, and bileaflet prolapse in 35. Among patients, 48 (22.9%) had associated severe tricuspid regurgitation and 45 (21.5%) had concomitant coronary artery disease. The mean number of chordae replaced per patient was 3.4 ± 2.6 (range: one to 16). The follow up period was 33.0 ± 17.3 months and was completed in 86.6% of patients.
Results: There were four early (in-hospital) deaths, and nine late deaths. Actuarial survival rates at three and
six years were 94% and 90%, respectively. Nineteen patients (10.3%) required reoperation due to recurrent severe mitral regurgitation (MR). Valve re-repair was feasible in nine patients (47.4%), but 10 patients (52.6%) required valve replacement. Rates of freedom from reoperation and recurrent MR were 92% and 88% after three and six years, respectively. Logistic regression analysis identified female gender as the sole predictor of reoperation in this study.
Conclusion: Chordal replacement with complete leaflet preservation for mitral valve repair offers a good surgical option, with reliable short- and mid-term outcomes. Female gender was a predictor for reoperation in the study cohort. Further long-term studies are required to evaluate other causes of reoperation.
Presented as a poster at the 4th Heart Valve Society Meeting, 12th-14th April 2018, Grand Hyatt Hotel, New York, USA
The Journal of Heart Valve Disease 2018-19;27:314-323
|Mid-Term Outcomes of Chordal Replacement for Repair of Prolapsed Mitral Valve: A Single-Center Experience|
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