Clinical efficacy of overall repair technique for rheumatic mitral valve lesions: A retrospective study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HOU Ming , LIU Yong , ZHANG Ning , TAN Xiong , WANG Liang , ZHANG Jian , JIN Weitao , LIAN Hongmei ,  LAI Yinglong

Department of Cardiovascular Surgery, Affiliated Hospital of Sichuan North Medical College, Nanchong, 637000, Sichuan, P. R. China;

Corresponding author：

LAI Yinglong, Email: laiyinglong2000@163.com

Keywords：

Rheumatic mitral valve; mitral valve overall repair; clinical efficacy; hemodynamics

DOI：

10.7507/1007-4848.202312051

Video：

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Objective To investigate the clinical efficacy of mitral valve repair technique in the treatment of rheumatic mitral valve lesions. Methods The clinical data of patients diagnosed with rheumatic mitral valve lesions and undergoing mitral valve repair under extracorporeal circulation in our department from 2021 to 2022 were retrospectively analyzed. Results A total of 100 patients were collected, including 78 females and 22 males with an average age of 52 years. There were no secondary open heart or death in the whole group. Extracorporeal circulation time was 136.3±33.1 min, aortic cross-clamping time was 107.6±27.5 min, ventilator use time was 12.9±5.9 h, ICU stay was 2.6±1.4 d, and vasoactive medication use was 823.4±584.4 mg. Before and after the surgery, there were statistical differences in the left ventricular end diastolic diameter, left atrial end systolic diameter, effective mitral valve orifice area, shortening rate of left ventricular short axis, mitral E-peak blood flow velocity, mean mitral transvalvular pressure difference, mitral pressure half-time, and cardiac function graded by New York Heart Association (P＜0.05). While there was no statistical difference in left ventricular ejection fraction or left ventricular end-diastolic volume (P>0.05). Conclusion Overall repair of rheumatic mitral valve lesions can significantly improve the cardiac function and hemodynamics of the patients, and is a good choice for patients with rheumatic mitral valve lesions.

Citation： HOU Ming, LIU Yong, ZHANG Ning, TAN Xiong, WANG Liang, ZHANG Jian, JIN Weitao, LIAN Hongmei, LAI Yinglong. Clinical efficacy of overall repair technique for rheumatic mitral valve lesions: A retrospective study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(6): 867-871. doi: 10.7507/1007-4848.202312051 Copy

1.	Fu J, Li Y, Zhang H, et al. Outcomes of mitral valve repair compared with replacement for patients with rheumatic heart disease. J Thorac Cardiovasc Surg, 2021, 162(1): 72-82.
2.	Chen SW, Chen CY, Chien-Chia Wu V, et al. Mitral valve repair versus replacement in patients with rheumatic heart disease. J Thorac Cardiovasc Surg, 2022, 164(1): 57-67.
3.	Watkins DA, Johnson CO, Colquhoun SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med, 2017, 377(8): 713-722.
4.	Yang S, Hu H, Lin M, et al. Medium long-term follow-up outcomes of BalMedic® bovine pericardial bioprosthetic valve in the mitral position. J Thorac Dis, 2021, 13(6): 3652-3659.
5.	Fishbein GA, Fishbein MC. Mitral valve pathology. Current Cardiology Reports, 2019, 21(7): 61.
6.	Beaton A, Okello E, Rwebembera J, et al. Secondary antibiotic prophylaxis for latent rheumatic heart disease. N Engl J Med, 2022, 386(3): 230-240.
7.	de Loizaga SR, Beaton AZ, Nascimento BR, et al. Diagnosing rheumatic heart disease: Where are we now and what are the challenges? Expert Rev Cardiovasc Ther, 2021, 19(9): 777-786.
8.	Dougherty S, Okello E, Mwangi J, et al. Rheumatic heart disease: JACC Focus Seminar 2/4. J Am Coll Cardiol, 2023, 81(1): 81-94.
9.	Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. J Am Coll Cardiol, 2019, 74(20): 2529-2532.
10.	Roth GA, Mensah GA, Fuster V. The global burden of cardiovascular diseases and risks: A compass for global action. J Am Coll Cardiol, 2020, 76(25): 2980-2981.
11.	Liao YB, Wang TKM, Wang MTM, et al. Meta-analysis of mitral valve repair versus replacement for rheumatic mitral valve disease. Heart Lung Circ, 2022, 31(5): 705-710.
12.	Uchino G, Murakami H, Mukohara N, et al. Very-long-term outcomes of mechanical valves in mitral position focusing on valve-related complications. Interact Cardiovasc Thorac Surg, 2022, 35(2): ivac146.
13.	Weich H, Herbst P, Smit F, et al. Transcatheter heart valve interventions for patients with rheumatic heart disease. Front Cardiovasc Med, 2023, 10: 1234165.
14.	Simpson MT, Kachel M, Neely RC, et al. Rheumatic heart disease in the developing world. Struct Heart, 2023, 7(6): 100219.
15.	Luo T, Meng X. Clinico-pathological classification of rheumatic mitral valve damage and surgical strategy. J Thorac Dis, 2021, 13(5): 2933-2941.
16.	中华医学会胸心血管外科分会瓣膜病外科学组. 风湿性二尖瓣病变外科治疗指征中国专家共识. 中华胸心血管外科杂志, 2022, 38(3): 132-137.
17.	Luo T, Meng X, Yan Z, et al. Commissuroplasty as a main operative technique in rheumatic mitral valve repair: Surgical experiences and mid-term results. Heart Lung Circ, 2020, 29(6): 940-948.
18.	韩仲仪, 谢恩泽华, 杨秀滨. 风湿性二尖瓣狭窄的瓣膜外科修复研究进展. 中国胸心血管外科临床杂志, 2023, 30(10): 1513-1518.
19.	Wunderlich NC, Dalvi B, Ho SY, et al. Rheumatic mitral valve stenosis: Diagnosis and treatment options. Curr Cardiol Rep, 2019, 21(3): 14.
20.	Harb SC, Griffin BP. Mitral valve disease: A comprehensive review. Curr Cardiol Rep, 2017, 19(8): 73.
21.	Jiang Y, Wang C, Li G, et al. Clinical outcomes following surgical mitral valve repair or replacement in patients with rheumatic heart disease: A meta-analysis. Ann Transl Med, 2021, 9(3): 204.

1. Fu J, Li Y, Zhang H, et al. Outcomes of mitral valve repair compared with replacement for patients with rheumatic heart disease. J Thorac Cardiovasc Surg, 2021, 162(1): 72-82.
2. Chen SW, Chen CY, Chien-Chia Wu V, et al. Mitral valve repair versus replacement in patients with rheumatic heart disease. J Thorac Cardiovasc Surg, 2022, 164(1): 57-67.
3. Watkins DA, Johnson CO, Colquhoun SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med, 2017, 377(8): 713-722.
4. Yang S, Hu H, Lin M, et al. Medium long-term follow-up outcomes of BalMedic® bovine pericardial bioprosthetic valve in the mitral position. J Thorac Dis, 2021, 13(6): 3652-3659.
5. Fishbein GA, Fishbein MC. Mitral valve pathology. Current Cardiology Reports, 2019, 21(7): 61.
6. Beaton A, Okello E, Rwebembera J, et al. Secondary antibiotic prophylaxis for latent rheumatic heart disease. N Engl J Med, 2022, 386(3): 230-240.
7. de Loizaga SR, Beaton AZ, Nascimento BR, et al. Diagnosing rheumatic heart disease: Where are we now and what are the challenges? Expert Rev Cardiovasc Ther, 2021, 19(9): 777-786.
8. Dougherty S, Okello E, Mwangi J, et al. Rheumatic heart disease: JACC Focus Seminar 2/4. J Am Coll Cardiol, 2023, 81(1): 81-94.
9. Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. J Am Coll Cardiol, 2019, 74(20): 2529-2532.
10. Roth GA, Mensah GA, Fuster V. The global burden of cardiovascular diseases and risks: A compass for global action. J Am Coll Cardiol, 2020, 76(25): 2980-2981.
11. Liao YB, Wang TKM, Wang MTM, et al. Meta-analysis of mitral valve repair versus replacement for rheumatic mitral valve disease. Heart Lung Circ, 2022, 31(5): 705-710.
12. Uchino G, Murakami H, Mukohara N, et al. Very-long-term outcomes of mechanical valves in mitral position focusing on valve-related complications. Interact Cardiovasc Thorac Surg, 2022, 35(2): ivac146.
13. Weich H, Herbst P, Smit F, et al. Transcatheter heart valve interventions for patients with rheumatic heart disease. Front Cardiovasc Med, 2023, 10: 1234165.
14. Simpson MT, Kachel M, Neely RC, et al. Rheumatic heart disease in the developing world. Struct Heart, 2023, 7(6): 100219.
15. Luo T, Meng X. Clinico-pathological classification of rheumatic mitral valve damage and surgical strategy. J Thorac Dis, 2021, 13(5): 2933-2941.
16. 中华医学会胸心血管外科分会瓣膜病外科学组. 风湿性二尖瓣病变外科治疗指征中国专家共识. 中华胸心血管外科杂志, 2022, 38(3): 132-137.
17. Luo T, Meng X, Yan Z, et al. Commissuroplasty as a main operative technique in rheumatic mitral valve repair: Surgical experiences and mid-term results. Heart Lung Circ, 2020, 29(6): 940-948.
18. 韩仲仪, 谢恩泽华, 杨秀滨. 风湿性二尖瓣狭窄的瓣膜外科修复研究进展. 中国胸心血管外科临床杂志, 2023, 30(10): 1513-1518.
19. Wunderlich NC, Dalvi B, Ho SY, et al. Rheumatic mitral valve stenosis: Diagnosis and treatment options. Curr Cardiol Rep, 2019, 21(3): 14.
20. Harb SC, Griffin BP. Mitral valve disease: A comprehensive review. Curr Cardiol Rep, 2017, 19(8): 73.
21. Jiang Y, Wang C, Li G, et al. Clinical outcomes following surgical mitral valve repair or replacement in patients with rheumatic heart disease: A meta-analysis. Ann Transl Med, 2021, 9(3): 204.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy of overall repair technique for rheumatic mitral valve lesions: A retrospective study in a single center

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