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Mitral valve repair--early and medium-term results
Hung-Wen Tsai1, Chung-Chi Wang, Hao-Ji Wei
1Division of Cardiovascular Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|June 5, 2003
Summary
Mitral valve repair offers excellent early and medium-term results for mitral insufficiency, demonstrating acceptable mortality and complication rates. This surgical approach provides significant functional improvement compared to mechanical valves.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Thoracic Medicine
Background:
- Mitral valve repair is the preferred treatment for mitral insufficiency.
- Mechanical valves have hemodynamic limitations and risks like thromboembolism and hemorrhage.
- Long-term studies support the durability of mitral valve repair.
Purpose of the Study:
- To evaluate the outcomes of mitral valve repair.
- To assess operative mortality, complications, and functional improvement.
- To compare repair durability against mechanical valve limitations.
Main Methods:
- 89 consecutive patients underwent mitral valve repair (Nov. 1997-Jan. 2002).
- Posterior annuloplasty used Carpentier rings or polytetrafluoroethylene strips.
- Techniques included quadrangular resection, artificial chordae replacement, and chordal shortening.
Main Results:
- 5 early deaths (4 in ischemic group) and 9 major complications (5 in ischemic group).
- Mean follow-up was 25.18 months; one late death and one thromboembolic event.
- Significant improvement in New York Heart Association functional class and mitral regurgitation grade.
Conclusions:
- Mitral valve repair demonstrates acceptable operative mortality.
- The procedure yields excellent early and medium-term results.
- Postoperative complication rates are favorable, supporting repair over replacement.