Improved results with mital valve repair using new surgical techniques
| Autor: | L. Torracca, Ottavio Alfieri, C. Fucci, Alessandro Pardini, L. Sandrelli, Maurizio Ferrari |
|---|---|
| Přispěvatelé: | Fucci, C, Sandrelli, L, Pardini, A, Torracca, L, Ferrari, M, Alfieri, Ottavio |
| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_treatment Myocardial Ischemia Postoperative Complications Actuarial Analysis Risk Factors Cause of Death Mitral valve Child Polytetrafluoroethylene Aged 80 and over Endocarditis Mitral Valve Insufficiency General Medicine Middle Aged Survival Rate medicine.anatomical_structure Child Preschool Heart Valve Prosthesis cardiovascular system Cardiology Chordae Tendineae Mitral Valve Female Cardiology and Cardiovascular Medicine Adult Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Reconstructive surgery Adolescent Heart Diseases Postoperative Hemorrhage Thromboembolism Internal medicine medicine Humans Risk factor Survival rate Aged Mitral valve repair Mitral regurgitation business.industry Suture Techniques Rheumatic Heart Disease medicine.disease Surgery Etiology business Follow-Up Studies |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 9:621-627 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/s1010-7940(05)80107-1 |
| Popis: | From January 1987 to July 1994, 299 consecutive patients ranging from 4 to 80 years of age underwent mitral repair for pure valve insufficiency due to degenerative disease (59%), rheumatic disease (23%), endocarditis (12%) or ischemic heart disease (6%). During the initial period, a variety of reparative methods were used following the principles originally described by Carpentier. More recently, in our institution other surgical techniques have been introduced: specifically, prolapse of the anterior leaflet was corrected either by replacing the chordae with polytetrafluoroethylene (PTFE) sutures or simply by anchoring the prolapsing free edge to the facing edge of the posterior leaflet ("edge-to-edge" technique). Chordal transposition has also been used occasionally to correct the prolapse of the anterior leaflet. The hospital mortality rate was 1.3%. According to actuarial methods, the overall survival rate was 94% at 7 years, and freedom from reoperation was 86%. Significant incremental risk factors for reoperation were: no use of prosthetic ring, correction of the prolapse of the anterior leaflet by triangular resection or chordal shortening and ischemic etiology of the mitral insufficiency (freedom from reoperation at 7 years was 61%, 56% and 51%, respectively). In the late postoperative period (mean follow-up 3.6 years), 95% of the patients were in NYHA class I or II; four patients had thromboembolic episodes, two hemorrhagic complications and two endocarditis. No patient in whom the prolapse of the anterior leaflet was corrected by the recently introduced technique has required reoperation. The anterior mitral leaflet prolapse was therefore neutralized as an incremental risk factor for reoperation and this has contributed to the improved overall results of mitral valve repair. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|