Costa FDAD, Colatusso DDFF, Martin GLDS, Parra KCS, Botta MC, Balbi Filho EM, Veloso M, Miotto G, Ferreira ADDA, Colatusso C. Long-Term Results of Mitral Valve Repair.
Braz J Cardiovasc Surg 2018;
33:23-31. [PMID:
29617498 PMCID:
PMC5873787 DOI:
10.21470/1678-9741-2017-0145]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 07/26/2017] [Indexed: 11/05/2022] Open
Abstract
Introduction
Current guidelines state that patients with severe mitral regurgitation
should be treated in reference centers with a high reparability rate, low
mortality rate, and durable results.
Objective
To analyze our global experience with the treatment of organic mitral
regurgitation from various etiologies operated in a single center.
Methods
We evaluated all surgically treated patients with organic mitral
regurgitation from 2004-2017. Patients were evaluated clinically and by
echocardiography every year. We determined early and late survival rates,
valve related events and freedom from recurrent mitral regurgitation and
tricuspid regurgitation. Valve failure was defined as any mitral
regurgitation ≥ moderate degree or the need for reoperation for any
reason.
Results
Out of 133 patients with organic mitral regurgitation, 125 (93.9%) were
submitted to valve repair. Mean age was 57±15 years and 52 patients
were males. The most common etiologies were degenerative disease (73
patients) and rheumatic disease (34 patients). Early mortality was 2.4% and
late survival was 84.3% at 10 years, which are similar to the age- and
gender-matched general population. Only two patients developed severe mitral
regurgitation, and both were reoperated (95.6% at 10 years). Freedom from
mitral valve failure was 84.5% at 10 years, with no difference between
degenerative and rheumatic valves. Overall, late ≥ moderate tricuspid
regurgitation was present in 34% of the patients, being more common in the
rheumatic ones. The use of tricuspid annuloplasty abolished this
complication.
Conclusion
We have demonstrated that mitral regurgitation due to organic mitral valve
disease from various etiologies can be surgically treated with a high repair
rate, low early mortality and long-term survival that are comparable to the
matched general population. Concomitant treatment of atrial fibrillation and
tricuspid valve may be important adjuncts to optimize long-term results.
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