Safety and durability of mitral valve repair for anterior leaflet perforation
| Autor: | Thomas A. Orszulak, Heidi M. Connolly, Rakesh M. Suri, Basar Sareyyupoglu, Hartzell V. Schaff, Richard C. Daly |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Perforation (oil well) Regurgitation (circulation) Severity of Illness Index Young Adult Internal medicine Mitral valve medicine Endocarditis Humans 35.4 cardiovascular diseases Cardiac Surgical Procedures Aged Retrospective Studies Mitral valve repair Anterior leaflet Mitral regurgitation business.industry Mitral Valve Insufficiency Middle Aged 35.4.1 medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Concomitant Cardiology cardiovascular system Female Safety business Cardiology and Cardiovascular Medicine |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. (6):1488-1493 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2009.07.040 |
| Popis: | ObjectiveWe sought to evaluate mitral valve repair for anterior leaflet perforation.MethodsBetween October 1987 and October 2006, 26 patients with mitral valve anterior leaflet perforation underwent mitral valve repair (median age, 54 years; 18 [69%] were male).ResultsThe indication for operation was severe mitral regurgitation only in 14 patients, both aortic regurgitation and mitral regurgitation in 11, and ventricular septal defect repair in 1. Twenty-four (92%) patients had endocarditis and 13 (50%) had at least mild aortic regurgitation preoperatively. Left atriotomy was performed in 17 (65%) and aortotomy in 8 (31%). Six (23%) patients had visible vegetations at the time of repair. For anterior leaflet repair, a patch was used in 11 (42%) patients and primary suture closure in 15 (58%). Eighteen patients underwent concomitant cardiac surgical procedures. Postoperative follow-up (mean, 6 years) was available for 25 (96%) patients. There was 1 early death from multiorgan failure and 2 late deaths. Patient survival was 95% at 1 year and 90% at 5 years. Left ventricular end-diastolic dimension improved significantly after mitral valve repair at dismissal (n = 16; −9.4 mm; P < .01) and during follow-up (n = 11; −10.8 mm; P < .01). Only 1 (4%) patient had mitral valve reoperation after 7 years owing to recurrent endocarditis 6 months after repair.ConclusionsMitral valve anterior leaflet perforation may be safely repaired with good midterm survival and durability. |
| Databáze: | OpenAIRE |
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