Safety and durability of mitral valve repair for anterior leaflet perforation

Basar Sareyyupoglu, Hartzell V Schaff, Rakesh M. Suri, Heidi M. Connolly, Richard C. Daly, Thomas A. Orszulak

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: We sought to evaluate mitral valve repair for anterior leaflet perforation. Methods: Between October 1987 and October 2006, 26 patients with mitral valve anterior leaflet perforation underwent mitral valve repair (median age, 54 years; 18 [69%] were male). Results: The indication for operation was severe mitral regurgitation only in 14 patients, both aortic regurgitation and mitral regurgitation in 11, and ventricular septal defect repair in 1. Twenty-four (92%) patients had endocarditis and 13 (50%) had at least mild aortic regurgitation preoperatively. Left atriotomy was performed in 17 (65%) and aortotomy in 8 (31%). Six (23%) patients had visible vegetations at the time of repair. For anterior leaflet repair, a patch was used in 11 (42%) patients and primary suture closure in 15 (58%). Eighteen patients underwent concomitant cardiac surgical procedures. Postoperative follow-up (mean, 6 years) was available for 25 (96%) patients. There was 1 early death from multiorgan failure and 2 late deaths. Patient survival was 95% at 1 year and 90% at 5 years. Left ventricular end-diastolic dimension improved significantly after mitral valve repair at dismissal (n = 16; -9.4 mm; P < .01) and during follow-up (n = 11; -10.8 mm; P < .01). Only 1 (4%) patient had mitral valve reoperation after 7 years owing to recurrent endocarditis 6 months after repair. Conclusions: Mitral valve anterior leaflet perforation may be safely repaired with good midterm survival and durability.

Original languageEnglish (US)
Pages (from-to)1488-1493
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume139
Issue number6
DOIs
StatePublished - Jun 2010

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Mitral Valve
Safety
Aortic Valve Insufficiency
Mitral Valve Insufficiency
Endocarditis
Cardiac Surgical Procedures
Survival
Ventricular Heart Septal Defects
Reoperation
Sutures

Keywords

  • 2
  • 35
  • 35.4
  • 35.4.1

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Safety and durability of mitral valve repair for anterior leaflet perforation. / Sareyyupoglu, Basar; Schaff, Hartzell V; Suri, Rakesh M.; Connolly, Heidi M.; Daly, Richard C.; Orszulak, Thomas A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 139, No. 6, 06.2010, p. 1488-1493.

Research output: Contribution to journalArticle

Sareyyupoglu, Basar ; Schaff, Hartzell V ; Suri, Rakesh M. ; Connolly, Heidi M. ; Daly, Richard C. ; Orszulak, Thomas A. / Safety and durability of mitral valve repair for anterior leaflet perforation. In: Journal of Thoracic and Cardiovascular Surgery. 2010 ; Vol. 139, No. 6. pp. 1488-1493.
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abstract = "Objective: We sought to evaluate mitral valve repair for anterior leaflet perforation. Methods: Between October 1987 and October 2006, 26 patients with mitral valve anterior leaflet perforation underwent mitral valve repair (median age, 54 years; 18 [69{\%}] were male). Results: The indication for operation was severe mitral regurgitation only in 14 patients, both aortic regurgitation and mitral regurgitation in 11, and ventricular septal defect repair in 1. Twenty-four (92{\%}) patients had endocarditis and 13 (50{\%}) had at least mild aortic regurgitation preoperatively. Left atriotomy was performed in 17 (65{\%}) and aortotomy in 8 (31{\%}). Six (23{\%}) patients had visible vegetations at the time of repair. For anterior leaflet repair, a patch was used in 11 (42{\%}) patients and primary suture closure in 15 (58{\%}). Eighteen patients underwent concomitant cardiac surgical procedures. Postoperative follow-up (mean, 6 years) was available for 25 (96{\%}) patients. There was 1 early death from multiorgan failure and 2 late deaths. Patient survival was 95{\%} at 1 year and 90{\%} at 5 years. Left ventricular end-diastolic dimension improved significantly after mitral valve repair at dismissal (n = 16; -9.4 mm; P < .01) and during follow-up (n = 11; -10.8 mm; P < .01). Only 1 (4{\%}) patient had mitral valve reoperation after 7 years owing to recurrent endocarditis 6 months after repair. Conclusions: Mitral valve anterior leaflet perforation may be safely repaired with good midterm survival and durability.",
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AB - Objective: We sought to evaluate mitral valve repair for anterior leaflet perforation. Methods: Between October 1987 and October 2006, 26 patients with mitral valve anterior leaflet perforation underwent mitral valve repair (median age, 54 years; 18 [69%] were male). Results: The indication for operation was severe mitral regurgitation only in 14 patients, both aortic regurgitation and mitral regurgitation in 11, and ventricular septal defect repair in 1. Twenty-four (92%) patients had endocarditis and 13 (50%) had at least mild aortic regurgitation preoperatively. Left atriotomy was performed in 17 (65%) and aortotomy in 8 (31%). Six (23%) patients had visible vegetations at the time of repair. For anterior leaflet repair, a patch was used in 11 (42%) patients and primary suture closure in 15 (58%). Eighteen patients underwent concomitant cardiac surgical procedures. Postoperative follow-up (mean, 6 years) was available for 25 (96%) patients. There was 1 early death from multiorgan failure and 2 late deaths. Patient survival was 95% at 1 year and 90% at 5 years. Left ventricular end-diastolic dimension improved significantly after mitral valve repair at dismissal (n = 16; -9.4 mm; P < .01) and during follow-up (n = 11; -10.8 mm; P < .01). Only 1 (4%) patient had mitral valve reoperation after 7 years owing to recurrent endocarditis 6 months after repair. Conclusions: Mitral valve anterior leaflet perforation may be safely repaired with good midterm survival and durability.

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