Mitral valve repair with the edge‐to‐edge technique: A 20 years single‐center experience
Autor: | Melchior Burri, Ruediger Lange, Stephanie Voss, Ralf Guenzinger, Konstantinos Sideris, Markus Krane, Anatol Prinzing, Bernhard Voss |
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Rok vydání: | 2021 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Mitral Valve Annuloplasty medicine.medical_treatment 030204 cardiovascular system & hematology Dehiscence Single Center 03 medical and health sciences 0302 clinical medicine Suture (anatomy) Mitral valve medicine Humans Cumulative incidence Aged Retrospective Studies Mitral regurgitation Mitral valve repair Mitral Valve Prolapse business.industry Mitral Valve Insufficiency Middle Aged Tailored treatment ddc Surgery Treatment Outcome medicine.anatomical_structure 030228 respiratory system Mitral Valve Cardiology and Cardiovascular Medicine business |
Zdroj: | Journal of Cardiac Surgery. 36:1298-1304 |
ISSN: | 1540-8191 0886-0440 |
DOI: | 10.1111/jocs.15377 |
Popis: | Objectives For tailored treatment of primary mitral regurgitation (MR), surgeons developed different repair techniques. One of them, the edge-to-edge repair has recently seen a revival, especially for Barlow's disease. Methods This study was designed to assess the outcomes of the edge-to-edge technique in mitral valve (MV) repair. Preoperative, periprocedural, and postoperative data were prospectively collected in a dedicated database and analyzed retrospectively. Results Between March 1999 and July 2019, a total of 152 patients (mean age: 60 ± 13) received an edge-to-edge repair combined with annuloplasty for degenerative MR at our institution. MR resulted from posterior leaflet prolapse in 23 patients (15.1%), anterior leaflet prolapse in 19 (12.5%), and bileaflet prolapse in 110 (72.4%). Of those who had a bileaflet prolapse, 91 (82.7%) had Barlow's disease. Follow-up was complete in 97.4% (6.4 ± 5.7 years). Echocardiographic assessment was achieved in 85.5% (5.1 ± 5.6 years). Overall survival after 10 years was 73.7 ± 5.0%. Twelve patients required valve-related reoperations due to ring dehiscence (n = 2), leaflet suture dehiscence (n = 2), progression of native valve disease (n = 6), or due to device failure (ring fracture) (n = 2). The cumulative incidence of valve-related reoperation at 10 years was 8.4 ± 3.0% (5.2 ± 4.1% in patients with Barlow's disease). At latest follow-up, echocardiography revealed excellent valve function with no or mild MR in 93 patients (88.6%). The mean gradient was 2.9 ± 1.3 mmHg at discharge and decreased to 2.4 ± 1.3 mmHg. Three patients (2.8%) had more than moderate MR. Conclusion Edge-to-edge MV repair is a simple method with excellent results in terms of valvular function and durability especially in patients with Barlow's disease. |
Databáze: | OpenAIRE |
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