Related Experiment Videos
Long-term performance of prostheses in mitral valve replacement
S D Moffatt-Bruce1, W R E Jamieson
1Division of Cardiovascular Surgery, University of British Columbia, Vancouver, Canada.
The Journal of Cardiovascular Surgery
|March 2, 2005
Summary
Mitral valve repair is preferred over replacement when possible. Mechanical prostheses risk hemorrhage, while bioprostheses may require reoperation due to deterioration.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Long-term data (up to 15 years) for current mitral valve prostheses are available.
- Mechanical prostheses have a 33-year history; bioprostheses have a 22-year history.
- Mechanical prostheses are associated with anticoagulation-related hemorrhage; bioprostheses risk late structural valve deterioration.
Purpose of the Study:
- To review the long-term performance and complications of mechanical and bioprosthetic mitral valve prostheses.
- To outline current indications for mitral valve replacement (MVR) versus mitral valve reconstruction.
- To discuss the role of mitral valve reconstruction, particularly with advancements in atrial fibrillation ablation.
Main Methods:
- Review of long-term performance data for mechanical and bioprosthetic mitral valve prostheses.
- Analysis of complication rates, including hemorrhage and structural valve deterioration.
- Evaluation of current surgical indications for mitral valve replacement and reconstruction based on valvular lesion type and patient status.
Main Results:
- Mechanical prostheses' primary complication is hemorrhage from anticoagulation.
- Bioprostheses are prone to reoperation for late structural valve deterioration.
- Mitral valve reconstruction is recommended over replacement when feasible, especially for degenerative disease.
Conclusions:
- Mitral valve reconstruction is preferred over replacement whenever possible.
- Indications for mitral valve replacement include lesions unsuitable for repair or with suboptimal reconstruction outcomes.
- Specific recommendations for mitral valve surgery are provided for mitral stenosis, non-ischemic mitral regurgitation, and ischemic mitral regurgitation.