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Mitral valve repair versus replacement with preservation of the entire subvalvular apparatus

Eiri Kisamori1, Satoru Otani2, Tsuyoshi Yamamoto2

  • 1Department of Cardiovascular Surgery, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atagocho, Iwakuni, Yamaguchi, 740-8510, Japan. e.kisamori@gmail.com.

General Thoracic and Cardiovascular Surgery
|November 25, 2018
PubMed
Abstract

Insights

Mitral valve (MV) replacement with subvalvular apparatus preservation showed similar operative mortality, long-term survival, and complication rates compared to MV repair. This approach is not inferior to traditional MV repair methods.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Surgical Outcomes

Background:

  • Mitral valve (MV) disease is a significant cardiac condition requiring surgical intervention.
  • Surgical options include mitral valve repair and mitral valve replacement.
  • Preservation of the subvalvular apparatus during MV replacement is a technique that warrants outcome evaluation.

Purpose of the Study:

  • To compare the clinical outcomes of mitral valve (MV) repair versus MV replacement with preservation of the entire subvalvular apparatus.
  • To assess operative mortality, long-term survival, and complication rates between the two surgical techniques.

Main Methods:

  • Retrospective analysis of patients undergoing MV surgery between 2012 and 2017.
  • Division of patients into MV replacement (n=35) and MV repair (n=47) groups.
  • Comparison of demographic data, mortality, long-term survival, and echocardiographic parameters.

Main Results:

  • No significant difference in 30-day mortality (MV replacement: 2.9% vs. MV repair: 0%; p=0.43).
  • Similar long-term survival rates between groups (p=0.07).
  • No significant differences in postoperative left ventricular dimensions and ejection fraction between MV replacement and MV repair.

Conclusions:

  • Mitral valve replacement with subvalvular apparatus preservation demonstrated comparable operative mortality and long-term survival to mitral valve repair.
  • No cardiac-related deaths occurred in the study cohort.
  • MV replacement with subvalvular apparatus preservation appears to be a viable alternative to MV repair.
Keywords:
Mitral valve repairMitral valve replacementSubvalvular apparatus preservation

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