Mid-term outcomes of mitral valve repair in a low-volume hospital

Mitral valve repair is feasible for all patients with mitral regurgitation and its advantages are well documented; however, there is general agreement that it is technically demanding and that success rates are related to volume/ experience centers. The aim of this study was to evaluate the clinical and echocardiographic mid-term outcomes of patients who underwent a mitral repair in a low-volume hospital.

Between 2009 and 2014, 55 patients (23 female) with mitral regurgitation underwent mitral repair. The mean age was 60.7±11.4 years (range, 21-81 yr). The most prevalent cardiovascular risk factors were: hypertension 61.8%, dyslipidemia 47.3% and diabetes 21.8%. Nine patients (16.4%) were in class III-IV of NYHA and ten (18.2%) had atrial fibrillation. Repair procedures included mitral ring annuloplasty (n=55), quadrangular resection (n=20), chordal replacement (n=13) and commissuroplasty (n=5). Postoperative complications included atrial fibrillation 16.4%, check bleeding 3.6%, wound infection 1.8% and renal failure 1.8%. The hospital mortality rate was 1.8%. Follow-up echocardiography (median 19±5 months) revealed trivial or no mitral regurgitation in 38.2%, mild (1+) in 34.5% and severe (3+) only in 3 patients.

In the current era, patients undergoing successful mitral valve repair have low mortality and morbidity even in low-volume hospitals.