Mitral valve repair with resection and non-resection techniques in Barlow's disease: A multi-center study.

Autor: Tomšič A; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands. Electronic address: a.tomsic@lumc.nl., Holubec T; Department of Cardiovascular Surgery, University Hospital and Goethe University Frankfurt, Frankfurt/Main, Germany., Sandoval E; Department of Cardiovascular Surgery, Hospital Clínic de Barcelona, Barcelona, Spain., Pham T; Department of Cardiovascular Surgery, University Hospital and Goethe University Frankfurt, Frankfurt/Main, Germany., Castella M; Department of Cardiovascular Surgery, Hospital Clínic de Barcelona, Barcelona, Spain., Klautz RJM; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands., Marsan NA; Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands., Pereda D; Department of Cardiovascular Surgery, Hospital Clínic de Barcelona, Barcelona, Spain., Palmen M; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Oct 15; Vol. 413, pp. 132387. Date of Electronic Publication: 2024 Jul 22.
DOI: 10.1016/j.ijcard.2024.132387
Abstrakt: Background: Various mitral valve (MV) repair techniques are nowadays in use. Non-resection techniques, that rely exclusively on Gore-Tex® neochords and annuloplasty, have been popularized; however, their efficacy in Barlow's disease, characterized by large myxomatous leaflets, is yet unclear.
Methods: Consecutive patients undergoing MV repair for Barlow's disease between 2011 and 2019 were selected on the basis of being eligible for resection and non-resection techniques. Study endpoints included overall survival, freedom from MV reintervention and recurrent regurgitation.
Results: Of 209 patients meeting the inclusion criteria, 135 (65%) underwent MV repair with and 74 (35%) without resection. There was one early reoperation due to residual regurgitation (resection group). Mean clinical follow-up duration was 6.1 (IQR 3.9-8.5) years. At 6 years after surgery, there was no difference in overall survival or freedom from MV reintervention. Mean echocardiographic follow-up (95% complete) duration was 3.5 (IQR 2.3-5.8) years. At 6 years, there was no difference in freedom from recurrent regurgitation rate (86.1%, 95% CI 78.5-93.7% vs. 83.0%, 95% CI 71.6-94.4%, P = 0.20) between the groups. Inverse probability-of-treatment weighting adjusted analysis demonstrated no significant difference between groups (HR 0.535, 95% CI 0.212-1.349, P = 0.20). Uni- and multivariable Cox proportional regression analysis did not demonstrate an effect of valve repair technique on the occurrence of recurrent regurgitation.
Conclusions: At mid-term, the clinical and echocardiographic results of valve repair for Barlow's disease were very good and MV reintervention was rarely needed. At this time point, the results of non-resection techniques were comparable to the "gold standard" resection techniques.
Competing Interests: Declaration of competing interest The authors have nothing to disclose.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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