Cor Vasa 2017, 59(1):e92-e96 | DOI: 10.1016/j.crvasa.2017.01.017

Surgical treatment of mitral regurgitation

Petr Němec^*, Jiří Ondrášek

Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika

Introduction: Mitral regurgitation (MiR) is very common valvular disease. Surgical treatment improves patients' prognosis and quality of their life. Traditional mitral valve replacement was mostly substituted by mitral valve repair which improved early and long-term survival. The aim of our study was to assess results of mitral valve surgery in our department.

Patients and methods: Retrospective study of data from cardiac operations registry was performed. From January 2009 to December 2014 seven hundred and eighty-six patients with mitral valve regurgitation were operated on. There were 471 men and 315 women, 78.9% of them were in NYHA class II or III. Functional etiology of MiR was in 56.4% patients mainly as a consequence of coronary artery disease, structural deterioration of the valve was in 43.6% mainly due to degenerative disease.

Results: Mitral valve repair was performed in 78.0% of patients; in the rest of patients the mitral valve was replaced mainly with bioprosthesis. Combined procedure involving particularly coronary artery bypass grafting and/or, tricuspid valve repair and/or maze procedure was performed in 59.5% patients. The most frequent postoperative complication was a new onset of atrial fibrillation in 34.8% of the patients. Low cardiac output syndrome (LCO) occured in 20.7%. Thirty-eight patients (4.8%) died within 30 days after operation.

Conclusion: Mitral valve repair is a method of choice in treatment of MiR. Successful long-lasting durability of the repair can be achieved by an experienced surgeon who is capable of using broad spectrum of different techniques and is able to tailor the proper technique for the specific patient. High quality of preoperative transthoracic and intraoperative transesophageal echocardiography involving 3D image is extremely important. Combined procedures are associated with more frequent occurrence of cardiac and extra cardiac complications and prolonged stay in the hospital.

Keywords: Combined procedure; Mitral regurgitation; Mitral valve repair; Surgical treatment

Received: December 9, 2016; Accepted: January 12, 2017; Published: February 1, 2017  Show citation