Objective: To compare the outcomes of mitral valve annuloplasty with support rings and that of the current technique employing an autopericardial strip in patients with degenerative diseases (patent RU2774033C1, June 14, 2022).Materials and methods: The study included 105 patients with degenerative mitral valve disease who underwent surgery in our clinic from May 2010 to January 2020. Depending on the conduit type, the patients were divided into two groups. Group I included 53 patients who underwent mitral valve annuloplasty with an autopericardial strip. Group II included 52 patients who underwent annuloplasty with a support ring. Male patients predominated in both groups: 59.6% and 57.7%, respectively. The mean age of patients was 54.9 ± 9.5 years (36–78 years) in group I and 54.8 ± 10.05 years (32–70 years) in group II. In most cases, tri- and quadrangular resections of the P2 segment were performed, and in some cases, neochords were implanted to the A2 segment.Results: There was 1 death in group II as a result of progressive cardiovascular and multiple organ failure while in group I no hospital mortality was reported. At the discharge, 81.1% of patients in group I and 59.6% of patients in group II had no mitral regurgitation.Conclusions: The current technique of mitral valve annuloplasty with an autopericardial strip in patients with degenerative diseases allows for adequate stabilization of the annulus fibrosus and improves the surgical outcomes in selected patients. With our proposed method of mitral valve annuloplasty, the suitable strip length can be chosen for each patient.
Objective: To present outcomes of mitral valve reinterventions for recurrent degenerative mitral regurgitation.Materials and methods: From May 2017 to February 2021 3 male patients aged 43, 50, and 54 years and an 18-year-old female patient underwent mitral valve reinterventions with an autopericardial strip at Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev. Three patients had primary mitral valve annuloplasty using a support ring and 1 patient using an autopericardial strip. In this patient group recurrent mitral regurgitation developed within 6-33 months between the primary repair and reintervention (20 ± 13.5 months on average).Results: No hospital mortality was reported. Cardiopulmonary bypass duration averaged 109.8 ± 19.7 minutes, and myocardial ischemia lasted 77.5 ± 10.1 minutes. Two patients had an adjunctive repeat radiofrequency Maze procedure, with the supraventricular rhythm restored in 1 patient. Echocardiography demonstrated that mitral regurgitation did not exceed grade 1 at discharge. Reintervention using an autopericardial strip for recurrent mitral regurgitation significantly reduces sizes of the left atrium and left ventricle. Ejection fraction did not change after the intervention. Mitral valve peak gradient in all cases did not exceed 9 mm Hg.Conclusions: The key to a successful mitral valve reintervention is a qualitative analysis of the recurrence causes and use of various techniques and materials for intervention on the mitral valvular complex. Mitral valve reinterventions, especially in young patients, are justified if certain safety conditions are met and have similar outcomes to primary interventions.
Aim. To examine an opportunity of sinus rhythm recovery in patients with mitral valve disease and atrial fibrillation (AF) by the means of surgery and concomitant procedures. Methods. 180 patients with AF who underwent mitral valve surgery using cardiopulmonary bypass in 2007-2011 were examined. Patients’ mean age was 52.5±0.5 years, 71 (39.4%) were male, 109 (60.6%) - female. Patients were divided into 3 groups: 22 patients with paroxysmal AF were included in Group I. 109 patients with persistent AF who underwent mitral valve surgery only were allocated to the Group II. 49 patients with persistent AF who underwent additional pulmonary vein isolation (radiofrequency ablation) were included in the Group III. Results. 83 (46.1%) of patients had single mitral valve disease, 62 (34.4%) of patients had multiple valve disease with involvement of tricuspid valve, 21 (11.7%) of patients had multiple valve disease with involvement of aortic valve, 21 (11.7%) of patients had all abovementioned valves involved. Mean arrhythmia duration was 36.3±3.8 months. Sinus rhythm was restored during the surgery in 16 (72.7%) patients of the Group I, in 60 (55.0%) patients of the Group II, in 41 (83.7%) patients of the Group III. Sinus rhythm was still registered at the discharge in 14 (63.6%), 19 (17.4%) and 13 (26.5%) respectively. Conclusion. It is possible to recover and hold regular rhythm in early postoperative period in more than 60% of cases in patients who underwent surgery for mitral valve disease and concomitant paroxysmal AF. Simultaneous radiofrequency ablation performed in patients with persistent AF increases sinus rhythm recovery rate in first day after surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.