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Mitral valve repair for degenerative disease
A Marc Gillinov1, Delos M Cosgrove
1Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Ohio, USA.
The Journal of Heart Valve Disease
|February 15, 2002
Summary
Mitral valve repair for degenerative disease is highly effective, with up to 90% of valves repaired. Ten-year freedom from reoperation is 93%, highlighting the durability of these surgical interventions.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Thoracic Surgery
Background:
- Degenerative mitral valve disease is a prevalent cause of mitral regurgitation in North America.
- Characterized by annular dilatation and chordal abnormalities, primarily affecting the posterior leaflet.
Purpose of the Study:
- To review current surgical techniques for repairing degenerative mitral valves.
- To assess the long-term durability and reoperation rates following mitral valve repair.
Main Methods:
- Overview of established repair techniques, including quadrangular resection, sliding repair, chordal transfer, artificial chords, and edge-to-edge repair.
- Emphasis on the integral role of annuloplasty in all repair procedures.
- Discussion of factors influencing reoperation risk and repair durability.
Main Results:
- Up to 90% of degenerative mitral valves can be successfully repaired.
- Ten-year freedom from reoperation after mitral valve repair is 93%.
- Optimal repair outcomes (98% 10-year durability) are achieved with specific techniques like quadrangular resection and annuloplasty, confirmed by intraoperative echocardiography.
Conclusions:
- Mitral valve repair is a durable and effective treatment for degenerative mitral valve disease.
- Specific surgical techniques and adjuncts like annuloplasty significantly impact long-term outcomes.
- Intraoperative echocardiography is crucial for confirming successful repair and optimizing durability.