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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Concomitant aortic and mitral surgery: to replace or repair the mitral valve?
Gonçalo F Coutinho1, Pedro M Correia1, Manuel J Antunes1
1Center of Cardiothoracic Surgery, University Hospital and Medical School, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal.
The Journal of Thoracic and Cardiovascular Surgery
|February 11, 2014
Summary
Mitral valve repair is preferred over replacement during concomitant mitral and aortic valve surgery. While survival rates are similar, repair reduces adverse events like bleeding and endocarditis, offering better long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Surgery
- Thoracic Surgery
Background:
- Concomitant mitral and aortic valve surgery is performed for complex valve disease.
- The choice between mitral valve repair and replacement impacts patient outcomes.
- Understanding perioperative results is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate perioperative outcomes of combined mitral and aortic valve surgery.
- To compare mitral valve repair versus replacement regarding survival and adverse events.
Main Methods:
- A cohort of 261 patients undergoing concomitant mitral and aortic valve surgery was analyzed.
- Mitral valve repair was performed in 80% and replacement in 20% of patients.
- Propensity-matched analyses compared outcomes between repair and replacement groups.
Main Results:
- Overall 30-day mortality was low (1.1%).
- Survival rates were comparable between mitral valve repair and replacement groups (8-year survival ~75-80%).
- Mitral valve replacement was associated with higher rates of bleeding, endocarditis, and reoperation, and increased major adverse valve-related events.
Conclusions:
- Concomitant mitral and aortic valve surgery has low surgical risk.
- Mitral valve procedure choice (repair vs. replacement) did not significantly impact survival.
- Mitral valve repair is associated with fewer adverse events and is preferable when feasible.
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