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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
Summary

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.

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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.