Non-ischaemic mitral valve suture annuloplasty: late follow-up results

Benetis, Rimantas; Orda, Paulius; Vaškelytė, Jolanta Justina; Ivanauskas, Vytenis; Ereminienė, Eglė; Jakuška, Povilas; Jankauskienė, Loreta

doi:10.1177/0267659116645398

Cited by 3 publications

(3 citation statements)

References 25 publications

(39 reference statements)

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“…The technique of suture annuloplasty is similar to the concept of the Paneth suture annuloplasty technique and has been previously reported. 7 Suture annuloplasty enables preservation of a natural annular movement in comparison to prosthetic annuloplasty. The contraction of the basal ventricular segments is restrained using a prosthetic annuloplasty and may have a negative impact late in the follow-up.…”

Section: Methodsmentioning

confidence: 99%

Changes in right ventricular longitudinal function: primary mitral and concomitant tricuspid valve repair

et al. 2018

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Objectives: To evaluate the impact of concomitant tricuspid valve (TV) repair on the right ventricular (RV) function postoperatively and within the 6 months following degenerative mitral valve (MV) repair. Methods: The prospective study included 37 patients (mean age 57.32 ± 2.13 years) with severe MV regurgitation due to primary MV prolapse. Nineteen underwent successful MV repair (TV(−) group). Additional TV repair due to moderate-to-severe TV regurgitation was performed in 18 (TV(+) group). Two-dimensional (2D) speckle-tracking and tissue Doppler echocardiography was performed for all patients before surgery and 7 days and 6 months after surgery. Results: Preoperative dimensions and indices of RV longitudinal function did not differ between the groups (right ventricle end-diastolic diameter (RVEDD) was 33.53 ± 0.94 mm vs. 34.67 ± 1.72 mm, tricuspid annular systolic motion (S’) was 15.06 ± 0.85 cm/s vs. 16.0 ± 1.27 cm/s, tricuspid annular plane systolic excursion (TAPSE) was 24.02 ± 1.06 mm vs. 22.4 ± 1.36 mm, respectively; p>0.05). RVEDD decreased significantly and did not change within the follow-up in the TV(−) group. In the TV(+) group, RVEDD decreased early after surgery and more markedly six months later in comparison to the TV(−) group. Indices of RV systolic longitudinal function decreased early after surgery and had a tendency to increase after six months in both groups. Regional longitudinal strains of the lateral RV wall decreased early after surgery and improved within the six months in the TV(−) group and did not change significantly in the TV(+) group. Conclusions: Additional TV repair in degenerative MV repair more markedly reduces RV dimensions and does not have a negative impact on RV systolic function in comparison to an isolated MV repair although these conclusions are of limited value due to the lack of a control group.

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Section: Methodsmentioning

confidence: 99%

Changes in right ventricular longitudinal function: primary mitral and concomitant tricuspid valve repair

et al. 2018

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“…Valve repair in MR inevitably aroused some suspicion as to its reproducibility and durability, and it was only in recent decades that it was recognized and prioritized as the technique of choice, to the point of being indicated even in asymptomatic patients in current guidelines. In a parallel experience, our center and others [ 9 , 10 , 12 , 13 , 20 ] chose not to adhere to the “mandatory” prosthetic ring implantation. The results obtained at that time were comparable to those published by authors who preferred ring implantation, and they continue to be today, as shown in this report.…”

Section: Discussionmentioning

confidence: 99%

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Kalil¹,

Belli²,

Mattos³

et al. 2021

Braz J Cardiovasc Surg

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Introduction Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes. Methods This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis. Results One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum follow-up was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P =0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P =0.049). Conclusion Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation.

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“…Left and right coronary ostia were implanted into the prosthesis with 5/0 and 4/0 Prolene sutures, respectively. Mitral valve (MV) annuloplasty was standardized in our center and was performed using double semi purse-suture annuloplasty with Teflon pledget reinforcement [10].…”

Section: Surgical Techniquesmentioning

confidence: 99%

Early Hemodynamics after Aortic Valve Replacement

et al. 2020

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Background and objectives: The aims of this study were to investigate changes in the hemodynamics associated with different types of aortic prostheses and to evaluate patient-prosthesis mismatch (PPM) at rest and after exercise. Materials and Methods: We retrospectively analyzed 150 patients who presented with indications for aortic valve replacement (AVR) with/without concomitant surgery from March 2019 to January 2020. The study population included 90 (60%) men and 60 (40%) women (mean age, 67.33 ± 10.22 years; range, 37–88 years). Echocardiography data such as peak and mean transprosthetic pressure gradients (Gmax, Gmean), velocity (V), effective orifice area (EOA), and indexed EOA (iEOA) were derived at rest and after exercise at baseline and before discharge. The study patients performed the six-minute walk test (6MWT) on the 5th–7th postoperative day. Results: Stented tissue valves showed excellent performance at rest and after exercise in comparison with mechanical valves, which showed favorable hemodynamics at rest only. At the time of discharge, moderate PPM was observed in 7/74 patients (9.5%) at rest and 5/98 (3.3%) patients after exercise. None of the patients showed severe PPM. EOA and iEOA were not significantly different between the groups. However, the stented group showed more pronounced changes in EOA and iEOA after exercise, whereas the changes in the mechanical valve group did not reach significance. Conclusions: In the early postoperative period, mechanical valves and stented valves showed favorable resting hemodynamics. The PPM rate measured after exercise was lower than that at rest.

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Non-ischaemic mitral valve suture annuloplasty: late follow-up results

Cited by 3 publications

References 25 publications

Changes in right ventricular longitudinal function: primary mitral and concomitant tricuspid valve repair

Changes in right ventricular longitudinal function: primary mitral and concomitant tricuspid valve repair

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Early Hemodynamics after Aortic Valve Replacement

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