Operative Outcomes with Myxomatous Mitral Valve Repair: Experience with 586 Patients

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Echocardiography

Background:

• American Heart Association (AHA) guidelines advocate for mitral valve repair in myxomatous mitral regurgitation to prevent left ventricular (LV) dysfunction and mortality.
• Mitral valve repair is preferred over replacement when feasible for myxomatous mitral regurgitation.
• Early operative outcomes of mitral valve repair for myxomatous mitral regurgitation require evaluation.

Purpose of the Study:

• To review early operative outcomes of mitral valve repair for myxomatous mitral regurgitation.
• To assess the safety and efficacy of mitral valve repair techniques.
• To evaluate patient outcomes in relation to surgical methods and preoperative conditions.

Main Methods:

• A retrospective review of 586 consecutive patients undergoing mitral repair for myxomatous disease (1997-2012).
• Pre- and postoperative transthoracic echocardiograms were utilized for assessment.
• Surgical techniques included resection, neochordal reconstruction, or a combination.

Main Results:

• Low early postoperative morbidity and mortality (deaths: 0.9%, strokes: 0.7%, TIAs: 0.9%).
• High rates of successful repair at discharge: 99% with MR ≤ mild, 79.5% with MR ≤ trivial.
• Neochordal reconstruction showed improved mitral regurgitation (MR) outcomes for posterior leaflet disease compared to resection (85% vs 78%, P<0.05).

Conclusions:

• Mitral valve repair for myxomatous mitral regurgitation yields excellent early results with low operative mortality.
• High rates of freedom from significant mitral regurgitation (MR) were achieved post-repair.
• The successful outcomes support early referral for mitral valve repair, aligning with current guidelines.