Mitral valve repair: the Manipal alternative.

Area of Science:

• Cardiovascular Surgery
• Biomaterials in Medicine

Background:

• Developing a reproducible, durable, and cost-effective mitral valve repair method is a significant clinical goal.
• Existing techniques often involve complex procedures or costly prosthetics requiring long-term anticoagulation.
• The described method aims to address these limitations in mitral valve repair.

Purpose of the Study:

• To present a novel, easily reproducible, and durable technique for mitral valve repair.
• To offer an alternative that avoids complex chordal procedures and expensive prostheses.
• To provide a method that does not necessitate long-term anticoagulation.

Main Methods:

• A custom ring was created from Dacron felt and autologous pericardium.
• Mitral commissurotomy and subvalvular apparatus mobilization were performed as needed.
• The ring was anchored to the mitral annulus, with specific suture placement and ring trimming, followed by pericommissural annuloplasty sutures.

Main Results:

• The technique was applied to 107 mitral valves between 1988 and 1997.
• A single hospital death occurred among 90 patients undergoing mitral valve repair (alone or combined).
• Long-term follow-up showed 80% of survivors in NYHA class I and 70% free from clinical mitral regurgitation.

Conclusions:

• This mitral valve repair technique is simple, cost-effective, and provides gratifying results.
• It is effective for both acquired mitral valve disease and mitral valve prolapse.
• The repaired valves demonstrated sustained function over 10 years.