Abstract:
BACKGROUND:To assess the long-term results of the edge-to-edge mitral repair performed without annuloplasty in degenerative mitral regurgitation (MR). METHODS AND RESULTS:From 1993 to 2002, 61 patients with degenerative MR were treated with an isolated edge-to-edge suture without any annuloplasty. Annuloplasty was omitted in 36 patients because of heavy annular calcification and in 25 for limited annular dilatation. A double-orifice repair was performed in 53 patients and a commissural edge-to-edge in 8. Hospital mortality was 1.6%. Follow-up was 100% complete (mean length, 9.2±4.21 years; median, 9.7; longest, 18.1). Survival at 12 years was 51.3±7.75%. At the last echocardiographic examination, MR ≥3+ was demonstrated in 33 patients (55%). At 12 years, freedom from reoperation was 57.8±7.21% and freedom from recurrence of MR ≥3+ was 43±7.6%. Residual MR >1+ at hospital discharge was identified as a risk factor for recurrence of MR ≥3+ (hazard ratio, 3.8; 95% confidence interval, 1.7-8.2; P=0.001). In patients with residual MR ≤1+ immediately after surgery, freedom from MR ≥3+ at 5 and 10 years was 80±6% and 64±7.58%, respectively. CONCLUSIONS:In degenerative MR, the overall long-term results of the surgical edge-to-edge technique without annuloplasty are not satisfactory. Early optimal competence (residual MR ≤1+) was associated with higher freedom from recurrent severe regurgitation.
journal_name
Circulationjournal_title
Circulationauthors
De Bonis M,Lapenna E,Maisano F,Barili F,La Canna G,Buzzatti N,Pappalardo F,Calabrese M,Nisi T,Alfieri Odoi
10.1161/CIRCULATIONAHA.113.007885subject
Has Abstractpub_date
2014-09-09 00:00:00pages
S19-24issue
11 Suppl 1eissn
0009-7322issn
1524-4539pii
130/11_suppl_1/S19journal_volume
130pub_type
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