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Published on: May 26, 2023
Non-ischaemic mitral valve suture annuloplasty: late follow-up results
Rimantas Benetis1, Paulius Orda2, Jolanta Justina Vaškelytė3
1Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania Cardiac Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Objective:
To evaluate late outcomes after posterior mitral valve (MV) annulus double-suture annuloplasty for degenerative (non-ischaemic) MV insufficiency.
Design:
Between 2005 and 2011, 138 patients underwent MV repair using posterior MV double-suture annuloplasty and an additional 105 patients underwent tricuspid valve repair. The study protocol included operative mortality, reoperation rate and reasons, as well as echocardiographic parameters at pre- and postoperative and follow-up periods (2-9 years).
Results:
In-hospital mortality was 2/138 (1.45%). Early post operation, no regurgitation was noted in 74/136 (54.4%) patients, I(o) regurgitation was observed in 55/136 (40.4%), II(o) was observed in 6/136 (4.4%) and III(o) was observed in 1/136 (0.7%); during late follow-up (from 2 to 9 years), no regurgitation was observed in 21.6% patients, I(o) was observed in 58%, II(o) was observed in 17% and III(o) was observed in 3.4%. The mean preoperative anterolateral diameter of the MV annulus was 39.02±4.97 mm and, at late follow-up, it was 27.66±3.94 mm (p=0.000); at these same time points, left ventricular end-diastolic diameter (LVEDD) was 55.74±7.29 mm and 49.17±6.01 mm (p=0.000), respectively, and the left ventricular ejection fraction (LVEF) was 53.08±8.93% and 50.92±6.78%, respectively (p=0.007).
Conclusions:
This study demonstrates suture annuloplasty to be an effective treatment up to 9 years for degenerative mitral valve disease. This technique enables preservation of the posterior mitral valve annulus diameter with stable long-term (up to 9 years) reduction, a competent (no regurgitation/⩽II(o) regurgitation) MV in 96.6% of cases and positive left ventricular (LV) remodelling.
Insights
Posterior mitral valve double-suture annuloplasty effectively treats degenerative mitral valve disease for up to 9 years. This technique maintains a competent mitral valve (MV) and promotes positive left ventricular (LV) remodeling.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Mitral Valve Disease
Background:
- Degenerative mitral valve insufficiency requires effective surgical repair techniques.
- Long-term outcomes of posterior mitral valve annulus double-suture annuloplasty are not well-established.
Purpose of the Study:
- To evaluate the late outcomes of posterior mitral valve (MV) annulus double-suture annuloplasty for degenerative (non-ischaemic) MV insufficiency.
Main Methods:
- 138 patients underwent posterior MV double-suture annuloplasty between 2005-2011.
- Study assessed operative mortality, reoperation rates, and echocardiographic parameters.
- Follow-up periods ranged from 2 to 9 years.
Main Results:
- In-hospital mortality was 1.45%.
- Late follow-up showed no or mild regurgitation (grade ⩽II(o)) in 96.6% of patients.
- Significant reduction in MV annulus diameter and left ventricular end-diastolic diameter (LVEDD) was observed, with preserved left ventricular ejection fraction (LVEF).
Conclusions:
- Posterior mitral valve double-suture annuloplasty is an effective treatment for degenerative mitral valve disease up to 9 years.
- The technique provides stable long-term reduction of the posterior MV annulus diameter.
- It results in a competent MV and positive left ventricular (LV) remodeling.
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