A 20-year experience with mitral valve repair with artificial chordae in 608 patients

Salvador, Loris; Mirone, Salvatore; Bianchini, Roberto; Regesta, Tommaso; Patelli, Fabio; Minniti, Giuseppe; Masat, Mauro; Cavarretta, Elena; Valfré, Carlo

doi:10.1016/j.jtcvs.2007.12.026

Cited by 148 publications

(108 citation statements)

References 19 publications

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“…14 Since then, it has been widely used to repair anterior leaflet prolapse because of its long-term durability and safety. 15, 16 The present study shows that after implementation of artificial chordae implantation, the incidence of recurrent MR and mitral reoperation decreased. Despite the wide use of artificial chordae implantation, anterior leaflet or bileaflet prolapse remain known risk factors for recurrent MR after MV repair in both single-surgeon series and largevolume reference centers.…”

Section: Discussionsupporting

confidence: 52%

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Kim

Lee

Joo

et al. 2018

Circ J

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Background: This study investigated the consequences of recurrent mitral regurgitation (MR) after mitral valve (MV) repair in patients with degenerative MR and risk factors for recurrence. Methods and Results:From January 1990 to December 2015, 792 patients underwent MV repair due to degenerative MR. Recurrent MR was defined as moderate-to-severe MR on follow-up echocardiography. Mean follow-up duration was 8.71±5.58 years. During the follow-up period, MR recurred in 133 (16.8%) patients, and the MR recurrence-free rate at 20 years was 77.5±2.0%. In the recurrence group, the degree of MR decreased in 8 (6.0%) patients and was aggravated in 46 (34.6%) patients. Recurrent MR was associated with increased mortality and adverse left ventricular (LV) remodeling. Independent risk factors for MR recurrence were MV repair performed before 2000, preoperative atrial fibrillation, high LV end-diastolic dimension (LVEDD), prolapse of the isolated anterior leaflet or multiple segments, and absence of ring annuloplasty. Predictors of MR progression were high LVEDD and repair without artificial chordae implantation.Conclusions: Recurrent MR after MV repair in patients with degenerative MR showed a tendency to progress and was associated with increased mortality and adverse LV remodeling. Early referral for MV repair before development of atrial fibrillation and LV enlargement may reduce the risk of MR recurrence. Moreover, artificial chordae implantation and ring annuloplasty may assure the long-term durability of MV repair.

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Section: Discussionsupporting

confidence: 52%

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Kim

Lee

Joo

et al. 2018

Circ J

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“…This method has proven much more durable and reproducible. (13) Treatment of the annular dilatation is most frequently done by implantation of an annuloplasty ring. Initially, there were two devices based on two different concepts: the rigid (Carpentier) and the flexible ring (Duran).…”

Section: Technique Of Mitral Valve Repairmentioning

confidence: 99%

Mitral valve repair in rheumatics: Is it still worthwhile?

Antunes

2017

SAHJ

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Hospital, patients who had mitral valve repair lived longer than those who had valve replacement and freedom from reoperation was similar ( Figure 1). (6) One further advantage of valvuloplasty is that, if and when reoperation is needed, it can usually be performed with mortality similar to that of primary surgery. COMMENTARYProsthetic valve replacement is plagued by several types of complications which carry high mortality and morbidity. Among these, thromboembolism is the most feared. Thrombosis of mechanical prosthesis, especially, is a very lethal complication with a mortality rate of up to 60% and is more frequent in the mitral valve position.(1) On the other hand, degeneration of bioprostheses limits durability and requires multiple reoperations, especially in younger patients. In addition, the mortality rate of reoperations is higher than that of primary surgery. It varies with the pathology, the condition of the patient and the experience of the surgical team, but ranges from 3% to 10% in most reports.

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“…Myocardial protection was achieved with tepid blood cardioplegia, and mitral valve repair was performed according to previously described techniques (9). Briefly, a CV-4 expanded polytetrafluoroethylene (Gore-Tex; W. L. Gore & Associates, Flagstaff, AZ, USA) suture was used to resuspend the free edge of the prolapsed leaflet.…”

Section: Operative Approachmentioning

confidence: 99%

Mitral valve repair with the “respect” approach in dialysis-dependent patients: a single-center experience

et al. 2016

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A 20-year experience with mitral valve repair with artificial chordae in 608 patients

Abstract: Mitral valve repair with GORE-TEX artificial chordae is effective, safe, and associated with low operative mortality and low rates of valve-related complications at long-term follow-up. Artificial chordae showed excellent biologic adaptation, retaining flexibility and tension with time.

Cited by 148 publications

References 19 publications

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Mitral valve repair in rheumatics: Is it still worthwhile?

Mitral valve repair with the “respect” approach in dialysis-dependent patients: a single-center experience

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