Minimally-Invasive Mitral Valve Repair for Isolated Anterior Leaflet Cleft in a 66 Year Old Woman

Fleerakkers, Jelle; Degrieck, Ivan; Casselman, Filip

doi:10.1080/00015458.2015.11681130

Cited by 1 publication

(2 citation statements)

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“…As expected, there was a significant, immediate improvement in median grade of MR to 0 (0-1) after surgery (P < .001). Median hospital stay was 4.5 [3][4][5][6][7] days. There were no major adverse events and no operative mortality in the immediate and early postoperative period.…”

Section: Resultsmentioning

confidence: 99%

“…3,4 Most published reports about the surgical management of isolated MVC have been comprised of case reports or small case series. [5][6][7][8][9][10][11][12][13][14][15] Larger series have consisted of postmortem studies or have included patients who have additional cardiac defects. [16][17][18][19] An early, small surgical case series reported repair of isolated MVC via direct suturing or a pericardial patch in four patients.…”

Section: Commentmentioning

confidence: 99%

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Management of Isolated, Congenital Anterior Mitral Valve Cleft

Hargiss

Dearani

Taggart

2021

World J Pediatr Congenit Heart Surg

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Background: Isolated anterior mitral valve clefts (MVC) are rare congenital heart defects, and data are limited regarding the natural history and surgical outcomes for such isolated MVCs. Methods: We conducted a retrospective review of patients with congenital MVC who were evaluated at Mayo Clinic in Rochester, Minnesota between 1993 and 2020. Patients were separated into two cohorts: those who underwent surgical repair of the MVC and those who had not yet undergone repair. Baseline and postoperative clinical and echocardiographic data were analyzed. Results: Fourteen patients were included in the nonsurgical cohort and eight patients in the surgical cohort. Surgical repair was via primary median sternotomy (n = 6) or robot-assisted, minimally invasive (n = 2). All cleft repairs were performed by simple suture closure. Intraoperative evaluation of the clefts did not reveal additional structural factors that could account for the mitral regurgitation (MR). At latest follow-up of the surgical cohort, the median grade of MR was 1 (range 0-1), and median left ventricular ejection fraction was 65% (IQR 59%-67%), both similar to the immediate postoperative result. At latest follow-up, all patients in the nonsurgical cohort were NYHA Class 1, and median MR grade was 1. All patients were asymptomatic (NYHA Class 1). Conclusions: Our findings corroborate prior reports that MVC repair is safe and successful and is followed by a low rate of recurrent mitral valve dysfunction. Durable surgical repair of isolated, congenital MVC can be performed safely in select patients. The decision to intervene should be based on the severity of mitral regurgitation and patient symptoms rather than the presence of the MVC alone.

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