[Reconstructive techniques for complete mitral valve repair for mitral valve insufficiency]

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Mitral Valve Disease

Context:

• Mitral regurgitation (MR) significantly impacts cardiac function and patient prognosis.
• Prosthetic valve replacement carries risks of thromboembolism, endocarditis, and hemorrhagic complications.
• Mitral valve reconstruction presents a viable alternative to prosthetic replacement.

Purpose:

• To demonstrate reconstructive techniques for radical mitral valve repair.
• To evaluate the long-term performance and outcomes of mitral valve reconstruction.
• To compare reconstructive repair with prosthetic valve replacement.

Summary:

• Mitral valve reconstruction, particularly for prolapse-induced pure mitral regurgitation, achieved 89% freedom from reoperation at 5 years and 81% at 10 years.
• Specific techniques like leaflet resection-suture for mural leaflet prolapse and chordae tendineae replacement for anterior leaflet prolapse are highlighted.
• Prosthetic ring implantation enhances leaflet coaptation, reinforces sutures, and prevents annular dilatation, contributing to successful repair.

Impact:

• Reconstructive mitral valve repair provides better postoperative ventricular function and reduced morbidity compared to prosthetic replacement.
• Low incidence rates of thromboembolism (0.8%) and absence of endocarditis or hemorrhagic complications underscore the safety of reconstruction.
• This study supports mitral valve reconstruction as a durable and effective treatment for mitral regurgitation, improving long-term patient outcomes.