Clinical Analysis of Mitral Valve Repair for Patients with Mitral Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANGLei ¹ ,  WANGYun ² , MAYan-min ² , NALi-sha ³ , LIMing-liang ¹

1. Ningxia Medical University, Yinchuan 750004, P. R. China;
2. Cardiac Surgery, General Hospital of Ningxia Medical University, Yinchuan 750004, P. R. China;
3. Echocardiography Room, General Hospital of Ningxia Medical University, Yinchuan 750004, P. R. China;

Corresponding author：

WANGYun, Email: wywarrenw@hotmail.com

Keywords：

Mitral valvuloplasty; Cardiac surgical procedures; Surgical techniques

DOI：

10.7507/1007-4848.20150137

Video：

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Objective To evaluate the effectiveness of mitral valve repair for mitral regurgitation. Methods We retrospectively analyzed the clinical data of 47 patients underwent mitral repair in General Hospital of Ningxia Medical University between January 2010 and June 2014 year. There were 36 males and 11 females with age of 10 months to 65 years, mean age of 42.38±15.27 years. Results There was no operative death within follow-up time of 18±7 months (ranged 14 to 1 586 days). Mitral valve function was normal or traces regurgitation in 33 patients (70.21%). Mild mitral regurgitation occurred in 11 patients (23.40%). Postoperative transesophageal echocardiography showed that 2 patients (4.26%) had moderate regurgitation. They underwent mitral valve repair again and cured. One patient (2.13%) underwent mitral valve replacement because of moderate to severe regurgitation. The dimensions of left atrium and left ventricle obviously decreased and heart function improved significantly compared with preoperative ones. Conclusion Strict control of surgical indications for different valve disease, the use of mitral valve repair technique, mitral surgery can get a good clinical efficacy. Preoperative diagnosis by transesophageal echocardiography, intraoperative monitoring, and immediate postoperative assessment for mitral valve repair results provide good technical support.

Citation： FANGLei, WANGYun, MAYan-min, NALi-sha, LIMing-liang. Clinical Analysis of Mitral Valve Repair for Patients with Mitral Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(6): 536-539. doi: 10.7507/1007-4848.20150137 Copy

1.	Javier G, Castillo, MD, Anelechi C, et al. A near 100% repair rate for mitral valve prolapse is achievable in a reference center: implica-tions for future guidelines. J Thorac Cardiovasc Surg, 2012, 144(2): 308-312.
2.	Gammie JS, Zhao Y, Peterson ED, et al. Less-invasive mitral valve operations: trends and outcomes from the society of thoracic surgeons adult cardiac surgery database. Ann Thorac Surg, 2010, 90(5): 1401-1410.
3.	LaPar DJ, Ailawadi G, Isbell JM. Mitral valve repair rates correlate with surgeon and institutional experience. J Thorac Cardiovasc Surg, 2014, 148 (3): 995-1004.
4.	Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg, 2006, 82(3): 819-826.
5.	Beresniak A, Sabatier B, Achouh P, et al. Cost-effectiveness of mitral valve repair versus replacement by biologic or mechanical prosthesis. Ann Thorac Surg, 2013, 95(1): 98-104.
6.	Lawrie GM. Mitral valve repair vs replacement: current recommen-dations and long-term results. Cardiology Clinics, 1998, 16(3): 437-448.
7.	Heikkinen J, Biancari F, Lepojärvi M. Long-term outcome after mitral valve repair.Scandinavian Cardiovasc J, 2005, 39(4): 229-236.
8.	Carpentier A. Cardiac valve surgery—the French correction. J Thorac Cardiovasc Surg, 1983, 86 (3): 323-337.
9.	Joseph S, Coselli MD. Mitral valve repair historical evolution and what lies ahead. The Texas Heart, 2012, 39(6): 862-865.
10.	Byrne JG, Rezai K, Juan A. Surgical management of endocarditis: The Society of Thoracic Surgeons Clinical Practice Guideline. Ann Thorac Surg, 2011, 91(6): 2012-2019.
11.	Feringa HH, Shaw LJ, Poldermans D, et al. Mitral valve repair and replacement in endocarditis: a systematic review of literature. Ann Thorac Surg, 2007, 83(2): 564-570.
12.	Prakash P, Punjabi KM, Chan J. Technique for chordae replacement in mitral valve repair. Ann Thorac Surg, 2012, 94(6): 2139-2140.
13.	David TE, Armstrong S, Ivanov J. Chordal replacement with polytetrafluoroethylene sutures for mitral valve repair: A 25-year experience. J Thorac Cardiovasc Surg, 2013, 145(6): 1563-1569.
14.	Bortolotti U, Milano AD, Frater RW. Mitral valve repair with artificial chordae: a review of its history, technical details, long-term results, and pathology. Ann Thorac Surg, 2012, 93(2): 684-691.
15.	Hetzer R. Folding or plication technique in mitral valve repair: new or renamed? J Thorac Cardiovasc Surg, 2013, 145(6): 1686-1687.
16.	Alfieri O, De Bonis M. The role of the edge-to-edge repair in the surgical treatment of mitral regurgitation. J Card Surg, 2010, 25(5): 536-541.
17.	Feringa HH, Shaw LJ. Very long-term results (up to 17 years) with the double-orifice mitral valve repair combined with ring annuloplasty for degenerative mitral regurgitation. J Thorac Cardiovasc Surg, 2012, 144(5): 1019-1026.
18.	Maisano F, Schreuder JJ, Oppizzi M, et al. The double orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique. Eur J Cardiothorac Surg, 2000, 17(3): 201-205.
19.	Murala JS, Wolfenden HD, Youssef GS, et al. Finger fracture mitral valvuloplasty: a tribute to the pioneers of cardiac surgery. Med J Aust, 2007, 186(11): 605.
20.	Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg, 2006, 82(3) : 819-826.
21.	Bolling SF, Deeb GM, Brunsting LA, et al. Early outcome of mitral valve reconstruction in patients with end stage cardiomyopathy. J Thorac Cardiovasc Surg, 1995, 109(4) : 676-683.
22.	Kang DH, Kim JH, Rim JH, et al. Comparison of early surgery versus conventional treatment in asymptomatic severe mitral regurgita-tion. Circulation, 2009, 119(16): 797-804.

1. Javier G, Castillo, MD, Anelechi C, et al. A near 100% repair rate for mitral valve prolapse is achievable in a reference center: implica-tions for future guidelines. J Thorac Cardiovasc Surg, 2012, 144(2): 308-312.
2. Gammie JS, Zhao Y, Peterson ED, et al. Less-invasive mitral valve operations: trends and outcomes from the society of thoracic surgeons adult cardiac surgery database. Ann Thorac Surg, 2010, 90(5): 1401-1410.
3. LaPar DJ, Ailawadi G, Isbell JM. Mitral valve repair rates correlate with surgeon and institutional experience. J Thorac Cardiovasc Surg, 2014, 148 (3): 995-1004.
4. Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg, 2006, 82(3): 819-826.
5. Beresniak A, Sabatier B, Achouh P, et al. Cost-effectiveness of mitral valve repair versus replacement by biologic or mechanical prosthesis. Ann Thorac Surg, 2013, 95(1): 98-104.
6. Lawrie GM. Mitral valve repair vs replacement: current recommen-dations and long-term results. Cardiology Clinics, 1998, 16(3): 437-448.
7. Heikkinen J, Biancari F, Lepojärvi M. Long-term outcome after mitral valve repair.Scandinavian Cardiovasc J, 2005, 39(4): 229-236.
8. Carpentier A. Cardiac valve surgery—the French correction. J Thorac Cardiovasc Surg, 1983, 86 (3): 323-337.
9. Joseph S, Coselli MD. Mitral valve repair historical evolution and what lies ahead. The Texas Heart, 2012, 39(6): 862-865.
10. Byrne JG, Rezai K, Juan A. Surgical management of endocarditis: The Society of Thoracic Surgeons Clinical Practice Guideline. Ann Thorac Surg, 2011, 91(6): 2012-2019.
11. Feringa HH, Shaw LJ, Poldermans D, et al. Mitral valve repair and replacement in endocarditis: a systematic review of literature. Ann Thorac Surg, 2007, 83(2): 564-570.
12. Prakash P, Punjabi KM, Chan J. Technique for chordae replacement in mitral valve repair. Ann Thorac Surg, 2012, 94(6): 2139-2140.
13. David TE, Armstrong S, Ivanov J. Chordal replacement with polytetrafluoroethylene sutures for mitral valve repair: A 25-year experience. J Thorac Cardiovasc Surg, 2013, 145(6): 1563-1569.
14. Bortolotti U, Milano AD, Frater RW. Mitral valve repair with artificial chordae: a review of its history, technical details, long-term results, and pathology. Ann Thorac Surg, 2012, 93(2): 684-691.
15. Hetzer R. Folding or plication technique in mitral valve repair: new or renamed? J Thorac Cardiovasc Surg, 2013, 145(6): 1686-1687.
16. Alfieri O, De Bonis M. The role of the edge-to-edge repair in the surgical treatment of mitral regurgitation. J Card Surg, 2010, 25(5): 536-541.
17. Feringa HH, Shaw LJ. Very long-term results (up to 17 years) with the double-orifice mitral valve repair combined with ring annuloplasty for degenerative mitral regurgitation. J Thorac Cardiovasc Surg, 2012, 144(5): 1019-1026.
18. Maisano F, Schreuder JJ, Oppizzi M, et al. The double orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique. Eur J Cardiothorac Surg, 2000, 17(3): 201-205.
19. Murala JS, Wolfenden HD, Youssef GS, et al. Finger fracture mitral valvuloplasty: a tribute to the pioneers of cardiac surgery. Med J Aust, 2007, 186(11): 605.
20. Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg, 2006, 82(3) : 819-826.
21. Bolling SF, Deeb GM, Brunsting LA, et al. Early outcome of mitral valve reconstruction in patients with end stage cardiomyopathy. J Thorac Cardiovasc Surg, 1995, 109(4) : 676-683.
22. Kang DH, Kim JH, Rim JH, et al. Comparison of early surgery versus conventional treatment in asymptomatic severe mitral regurgita-tion. Circulation, 2009, 119(16): 797-804.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Analysis of Mitral Valve Repair for Patients with Mitral Regurgitation

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