Mitral Valve Repair Is Effective When Performed With Valve-Sparing Aortic Root Replacement

Concurrent aortic and mitral valve repair presents specific technical challenges to surgeons. Here we evaluate the outcomes of patients undergoing combined valve-sparing aortic root reimplantation and mitral valve repair.

We performed a retrospective review of patients at our center between 2006 and 2021 who underwent concomitant valve-sparing aortic root replacement and mitral valve repair. Patient characteristics, including preoperative and postoperative valve function, and operative outcomes were analyzed.

Between 2006 and 2021, 14 patients underwent valve-sparing aortic root replacement with concurrent mitral valve repair. Mean age of the patients at operation was 39 ± 20 years. Almost half of the patients (6/14) had Marfan disease. The primary indication for operation in all patients was aortic root dilation. Preoperatively, all patients (14/14) had moderate to severe mitral regurgitation, and half (7/14) had moderate to severe aortic regurgitation. Patients underwent mitral annuloplasty alone (9/14) or had concurrent leaflet repair (5/14). The median length of intubation was 0 day (interquartile range, 0-1 day), and median length of stay was 7 days (interquartile range, 6-10 days). At average follow-up of 6.8 ± 4.2 years, 13 of 14 patients had none to trace aortic and mitral regurgitation. One patient required reoperation for late recurrence of aortic and mitral regurgitation. There was no early or late cardiovascular mortality.

Mitral valve repair can be performed safely with excellent short-term and long-term results in selected patients undergoing valve-sparing aortic root reimplantation. For durable bivalvular repair to be achieved, specific technical considerations should be adhered to.