Isolated Mitral Valve Surgery: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis

Abstract

Patients undergoing primary isolated mitral valve operations commonly have ventricular dysfunction, atrial fibrillation, and heart failure. Although contemporary outcomes are excellent, earlier guideline-directed referral and increased frequency and quality of repair may further improve results of mitral valve operations.

Multisociety expert consensus systems of care document 2019 AATS/ACC/SCAI/STS expert consensus systems of care document: Operator and institutional recommendations and requirements for transcatheter mitral valve intervention: A Joint Report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons

“…The interim experience with the edge‐to‐edge clip device for MV repair as reported to the STS/ACC TVT Registry and described in landmark RCTs allows for greater clarity regarding standard setting for this specific intervention. Additional perspectives on surgical MVRR have been gained from registry analyses and RCTs . Newer transcatheter systems for the treatment of severe MR are anticipated and it is expected that the proposed requirements herein will need to evolve with further advances in equipment, techniques, and patient selection.…”

Contemporary trends and outcomes of mitral valve surgery for infective endocarditis

“…In 2016, one in four patients who underwent MV surgery for IE, had valve repair. These rates are in line with the reported rates of MV repair for IE in several single‐center studies but are lower than those reported for degenerative MV disease . Although speculative, this is likely multifactorial and may be more related to the pathoanatomy of the MV disease: it is likely that a lesser proportion of patients are deemed suitable for MV repair in the setting of IE than in the setting of degenerative primary MV disease, the availability of expertise in complex MV repair in areas where IE is epidemic, the limited short‐ and long‐term comparative outcomes data for repair vs replacement in patients with MV IE.…”

Commentary: Expanded polytetrafluoroethylene cordal implantation for mitral valve repair: The founder series

“…In the recent Society of Thoracic Surgeons adult cardiac surgery database experience, ePTFE cords were used in only one-third of repairs for degenerative leaflet prolapse, and among those patients undergoing ePTFE repairs, the median number of cordal pairs used was only 2. 2 It is likely that more cords are better than fewer cords.…”