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Mitral valve repair combined with aortic valve replacement
S Szentpetery1, J B Rich, H Azar
1Department of Surgery, Sentara Norfolk General Hospital, Virginia 23507, USA.
The Journal of Heart Valve Disease
|January 1, 1997
Summary
Combined aortic and mitral valve surgery with mitral repair offers excellent survival rates and no valve failures. This approach is ideal for patients who cannot use anticoagulation, demonstrating good long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Surgery
- Surgical Outcomes
Background:
- Combined aortic and mitral valve replacement (AVR) is associated with high morbidity and mortality.
- Mitral valve repair (MR) has improved outcomes in mitral valve surgery, but its impact on combined AVR is not well-established.
Purpose of the Study:
- To assess the outcomes of combined aortic valve replacement and mitral repair.
- To evaluate the safety and efficacy of this combined surgical approach.
Main Methods:
- Retrospective review of 38 patients undergoing AVR and MR between 1985 and 1995.
- Detailed analysis of patient demographics, risk factors, surgical techniques (including types of AVR and MR), and additional procedures.
- Follow-up assessment of patient survival, valve function, and complications.
Main Results:
- No operative deaths; 5- and 10-year survival rates of 75% and 67%, respectively.
- No instances of valve failure or endocarditis observed during follow-up.
- Logistic risk analysis identified female sex, rheumatic valve disease, bacterial endocarditis, and degenerated valves as significant factors.
Conclusions:
- Combined AVR and MR, with surgical expertise and improved myocardial protection, yields excellent short- and long-term results.
- This combined approach offers optimal chordal preservation, no valve failure, and no endocarditis, making it suitable for patients contraindicated for anticoagulation.
- Prolonged cross-clamp times were well-tolerated in this patient cohort.