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Related Experiment Videos

Prophylactic mitral reconstruction for mitral regurgitation.

I A Smolens1, F D Pagani, G M Deeb

  • 1Department of Surgery, University of Michigan Hospitals, Ann Arbor 48109-0348, USA.

The Annals of Thoracic Surgery
|October 18, 2001
PubMed
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Mitral valve reconstruction in asymptomatic patients with severe mitral regurgitation (MR) showed no deaths and low morbidity. Early prophylactic repair is recommended before left ventricular dysfunction develops.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Mitral Valve Disease

Background:

  • Severe mitral regurgitation (MR) can lead to myocardial dysfunction.
  • The study focuses on outcomes of mitral valve reconstruction in asymptomatic patients.
  • Degenerative MR is a common indication for surgical intervention.

Purpose of the Study:

  • To review the outcomes of mitral valve reconstruction in asymptomatic patients with severe MR.
  • To evaluate the safety and efficacy of prophylactic mitral valve repair.
  • To determine the long-term results of complex mitral valve reconstruction.

Main Methods:

  • A cohort of 93 asymptomatic patients with degenerative MR underwent mitral valve reconstruction between 1992 and 2000.
  • Patients had a mean preoperative left ventricular internal diameter of 56 mm and ejection fraction of 60%.

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  • All patients underwent complex valve reconstruction procedures with a mean follow-up of 23 months.

    • Main Results:

    • No perioperative deaths occurred.
    • Two late reoperations were required: one for systolic anterior motion and one for hemolysis.
    • No late thromboembolic events were observed, and most patients remained in NYHA class I with no significant MR at follow-up.

    Conclusions:

    • Mitral valve reconstruction for asymptomatic severe MR can be performed with no mortality and low morbidity.
    • Early prophylactic repair is advocated in severe MR cases with assured valve reparability.
    • This approach can prevent the development of left ventricular dysfunction.