Surgical treatment of mitral valve insufficiency by valve repair

Murad, Henrique; Gomes, Eliane Carvalho; Pinheiro, Adriana Alves; Azevedo, José Augusto de; Sá, Mauro Paes Leme de; Noronha, André Prado; Bastos, Eduardo Sérgio; Filho, Rubens Giambroni

doi:10.1590/s0102-76382002000400004

Cited by 5 publications

(10 citation statements)

References 17 publications

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“…Annuloplasty was the single procedure used in only eight of the patients studied (20%), thus demonstrating that in most of the cases (80%) the association with more than one technique was necessary, and in many occasions with modifications of the initial planning, a situation that has also been described by other authors 6,10,16 . Mitral annulus dilatation is present in almost all patients with mitral regurgitation.…”

Section: Discussionsupporting

confidence: 60%

“…Mitral valve repair is a technique universally accepted as superior to valve replacement, especially in children, in whom further replacements may be necessary as they grow 6,7,11 . The age of the patients ranged from four to 17 years at the moment of the surgical mitral repair.…”

Section: Discussionmentioning

confidence: 99%

“…In rheumatic fever, valve reconstruction is technically more difficult and the mid and long-term outcomes may be influenced by new bouts of the disease 6,9 . Initial studies presented techniques which addressed only the valve annulus treatment 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Mitral regurgitation results from annulus dilatation and changes in the papillary muscles, chordae tendineae and leaflets [4][5][6][7] . The available prostheses lead to complications which are difficult to be controlled, especially calcification and rupture in bioprostheses, thromboembolism in mechanical prostheses, and the need for continuous use of anticoagulation and its monitoring with periodic laboratory tests 8 .…”

Section: Introductionmentioning

confidence: 99%

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Plastia mitral cirúrgica em crianças com febre reumática

Silva¹,

Herdy²,

Vieira³

et al. 2009

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Plastia mitral cirúrgica em crianças com febre reumática

Silva¹,

Herdy²,

Vieira³

et al. 2009

Arq. Bras. Cardiol.

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“…When necessary, correction of the aortic and tricuspid valves was performed after the repair of the mitral valve. Tricuspid annuloplasty was only performed when the diameter of the ring was greater than twice the normal size (= 70 mm) irrespective of the degree of regurgitation [12]. The mean size of the tricuspid ring was 33.5 ± 0.8.…”

Section: Operative Techniquementioning

confidence: 99%

<![CDATA[Papillary muscle repositioning: the gold standard technique to repair anterior mitral leaflet prolapse]]>

Neto¹,

Aubert²,

Pawale³

et al. 2005

Braz. j. cardiovasc. surg.

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RBCCV 44205-773Reposicionamento do músculo papilar: a técnica padrão para plastia do prolapso da cúspide anterior da mitral Papillary muscle repositioning: the gold standard technique to repair anterior mitral leaflet prolapse Abstract Objective: The aim of this study was to demonstrate that papillary muscle repositioning is a reliable technique to repair anterior leaflet prolapse. Therefore we describe this technique and its long term results to propose it as a gold standard.Methods: Between 1989 and 2005, 120 mitral valve repairs were consecutively performed using papillary muscle repositioning in cases of anterior leaflet prolapse. There were 87 males and 33 females, the mean age was 59 ± 11.5 years. 59% of patients were in NYHA III or IV. Mean ejection fraction was 65.7 ± 8.9%. Predominant aetiology of mitral regurgitation (MR) was degenerative: Barlow (n=43) and dystrophic (n=62). The other aetiologies were: healed endocarditis (n=5), rheumatic (n=5), ischemic (n=4), congenital (n=1). A posterior papillary muscle repositioning was performed in 111 (92.5%) cases and an anterior in 38 (31.7%). Associated procedures were carried out in 76 (63.3%) patients.Results: There were no in-hospital deaths. During the follow-up, 14 patients (11.7%) died, including 7 (5.8%) due to cardiac causes. The cumulated survival rates at 1, 5, 10 and 15 years were 98.3%, 97.2%, 94.1% and 81.4% respectively. Two patients (1.7%) were reoperated for recurrency of the regurgitation, they underwent a replacement of the valve 1 and 5 years after the repair and died 3 and 6 years, respectively after this replacement. There was no systolic anterior motion. The cumulated survival rates free from reoperation involving the mitral valve at 1, 5, 10 and 15 years were 97.4%, 97.4%, 92.8 % and 86.7% respectively. We did not find any risk factor of mortality or of reoperation. The follow-up was completed for all the patients. After a median follow-up time of 5.9 years (range from 0.1 to 15.6 years) 87 patients were in NYHA class I (72.5%), the echocardiographic control showed no or minimal insufficiency in 89 patients (74.2%), mild insufficiency in 8 patients (6.7%) and moderate insufficiency in 9 patients (7.5%).Conclusions: Papillary muscle repositioning is a reliable and safe technique, with excellent clinical and echocardiographic long term results. Therefore we propose it as a gold standard to repair anterior leaflet prolapse. 0,1 a 15,6 anos), 87 (72,5%) pacientes estavam na classe I -NYHA, o controle ecocardiográfico mostrou nenhuma ou mínima regurgitação em 89 (74,2 %) pacientes, leve regurgitação em oito (6,7%) e moderada regurgitação em nove (7,5%). DescriptorsConclusão: O reposicionamento do músculo papilar é uma técnica confiável e segura, com excelentes resultados clínicos e ecocardiográficos a longo prazo. Desta maneira, estamos propondo-a como padrão para o reparo da cúspide anterior prolapsada.Descritores: Prolapso das valvas cardíacas. Insuficiência da valva mitral, cirurgia. Valva mitral, cirurgia.

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