Outcomes after mitral valve repair: A single-center 16-year experience

Tatum, James M.; Bowdish, Michael E.; Mack, Wendy J.; Quinn, Adrienne; Cohen, Robbin G.; Hackmann, Amy E.; Barr, Mark L.; Starnes, Vaughn A.

doi:10.1016/j.jtcvs.2017.01.047

Cited by 29 publications

(32 citation statements)

References 27 publications

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“…Grade 4 had complex MAC that may require some resection and annular reconstruction. [21][22][23][24] In our patient, prolapse of anterior leaflet is seen, with grade 3 disease, so surgery is more complex and requires intense surgical expertise. Generally, to correct AML prolapse caused by a ruptured or elongated chord, surgeon will create new Gore-Tex chords.…”

Section: Managementmentioning

confidence: 83%

“…20 Preoperative analysis of mitral valve prolapse is more important to achieve good results, so mitral valve repair is mainly divided as gradings. 21 There are mainly four grades, Grade 1 includes either annular dilatation or focal single-segment prolapse that is treated by triangular resection or PTFE neochords and annuloplasty. Grade 2 involves multiscallop involvement (clefts and myxoid leaflets) of posterior mitral leaflet (PML) with no or minimal involvement of the AML, which requires some part of PML height reduction.…”

Section: Managementmentioning

confidence: 99%

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Progeroid Syndrome with Mitral Regurgitation: A Rare Case Report

Chakravarthi

Kishore

Kumar

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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Progeroid syndromes (PS) involve the disorder of early aging. Although survival of progeria syndrome patients is nearly 15 years as per literature, the adult onset progeroid starts manifesting in the third decade. Here, we are presenting a rare case of progeroid at the age of 45 years with mitral regurgitation (MR). The patient has alopecia, dry skin, frontal bossing, up staring eyes with bilateral corneal opacities, prominent nose with parrot beak appearance, thin upper lip, large, low-set ears, periorbital hyperpigmentation, micrognathia, retrognathia, and hyperpigmentation over lower abdomen/both feet and hands. Facial and skeletal manifestation are the major clinical features of the PS; along with the characteristics mentioned above, the patient also had severe eccentric MR. This patient has PS with mitral valve prolapse and severe MR. Most of the features of progeria exist in this patient, which manifested at a younger age. However, the progression of the external features and survival up to 45 years favors PS instead of progeria. Therefore, genetic analysis is mandatory to confirm. We are reporting this case due to the rarity of onset of symptoms within a younger age group; however, the progression of the disease was very slow, which may be a another variant of progeria/PS.

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Section: Managementmentioning

confidence: 83%

Section: Managementmentioning

confidence: 99%

Progeroid Syndrome with Mitral Regurgitation: A Rare Case Report

Chakravarthi

Kishore

Kumar

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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“…The prevalence of reoperation due to recurrent MV regurgitation was recently reported 5% at 5 years and 9.5% at 10 years postoperatively. Nondegenerative valve etiology was shown to predict death after mitral valve repair [5]. We strongly consider redo MV surgery for failed repair in the FMR entity, especially in the setting of an obvious clinical deterioration and if re-repair seems possible, although clinical guidelines for this approach are very restrictive.…”

Section: Discussionmentioning

confidence: 99%

“…Reoperation rate due to the recurrence of MV regurgitation was recently reported 5% at 5 years and between 6.2 and 13.2% at 10 years postoperatively, not taking into account underlying valve pathology. Nondegenerative valve etiology was shown to predict death after mitral valve repair [5]. However, the echocardiographic and surgical variables associated with the recurrence of mitral regurgitation/redo mitral valve surgery after MV repair remain to be clarified.…”

Section: Introductionmentioning

confidence: 99%

Can We Predict Failure of Mitral Valve Repair?

Gasser¹,

Stumm²,

Sinning³

et al. 2019

JCM

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Objective: To identify echocardiographic and surgical risk factors for failure after mitral valve repair. Methods: We identified a total of 77 consecutive patients from our institutional mitral valve surgery database who required redo mitral valve surgery due to recurrence of mitral regurgitation after primary mitral valve repair. A control group of 138 patients who had a stable echocardiographic long-term result was included based on propensity score matching. Systematic analysis of echocardiographic parameters was performed before primary surgery; after mitral valve repair and prior to redo surgery. Risk factor analysis was performed using multivariate Cox regression model. Results: Redo surgery was associated with the presence of pulmonary hypertension ≥ 50 mmHg (p = 0.02), a mean transmitral gradient > 5 mmHg (p = 0.001), left ventricular ejection fraction ≤ 45% (p = 0.05) before surgery and mitral regurgitation ≥moderate at time of discharge (p = 0.002) in the whole cohort. Patients with functional mitral valve regurgitation had a higher tendency to undergo redo surgery if preoperative left ventricular end-diastolic diameter exceeded 65 mm (p = 0.043) and if postoperative tenting height exceeded 6 mm (p = 0.018). Low ejection fraction was not significantly associated with the need for redo mitral valve surgery in the functional subgroup. Conclusions: Recurrent mitral regurgitation is still a valuable problem and is associated with relevant perioperative mortality. Patients with severe mitral regurgitation should undergo early mitral valve repair surgery as long as systolic pulmonary artery pressure is low, left ventricular ejection fraction is preserved, and LVEED is deceeds 65 mm.

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“…Por outro lado, em pacientes sem indicação de revascularização, a abordagem cirúrgica isolada da IM está associada à elevada mortalidade, altas taxas de recorrência da IM e não há evidência de benefício em termos de sobrevida. 53,[57][58][59][60][61][62][63][64][65][66] Em pacientes com IM secundária a cardiomiopatia dilatada, a indicação de intervenção na valvopatia mitral é ainda mais restrita. Enquanto a cirurgia valvar mitral isolada não mostrou benefício nesse cenário, novas evidências mostraram benefício da intervenção transcateter em pacientes com IM secundária, FEVE ≥ 20% e sintomáticos a despeito de tratamento clínico otimizado, desde que o procedimento não seja indicado em fases mais avançadas da história natural da valvopatia.…”

Section: Insuficiência Mitral Secundáriaunclassified