What is the clinical evidence from this study?

Study design: Observational. Population: Mitral valve prolapse (n=632). Intervention: Mitral valve repair using premeasured Gore-Tex loops ('loop technique'). Primary outcome: Freedom from reoperation at 3 years.

What does this research mean for the field?

Mitral valve repair using premeasured Gore-Tex loops for mitral valve prolapse demonstrates excellent early and mid-term outcomes, achieving 98.6% 30-day survival and 97.4% freedom from reoperation at 3 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 14, 2008Open Access

Early and mid-term results of mitral valve repair using premeasured Gore-Tex loops (‘loop technique’)☆

Key Result

Mitral valve repair using premeasured Gore-Tex loops for mitral valve prolapse demonstrated excellent outcomes, with 98.6% 30-day survival and 97.4% freedom from reoperation at 3 years.

Study Design

Type

Observational (n=632)

Structured PICO

Does mitral valve repair using premeasured Gore-Tex loops provide good early and mid-term outcomes in patients with mitral valve prolapse?

Population

632 patients (447 male, 185 female) with mitral valve prolapse undergoing mitral valve repair.

Intervention

Mitral valve repair with premeasured Gore-Tex loops ('loop technique').

Outcome

Early postoperative echocardiographic results (residual mitral regurgitation), 30-day survival, 1-year survival, and freedom from reoperation at 3 years.hard clinical

Mitral valve repair using premeasured Gore-Tex loops is associated with excellent early and mid-term survival and freedom from reoperation, with low rates of residual mitral regurgitation.

Abstract

OBJECTIVE: Mitral valve (MV) repair with premeasured Gore-Tex loops (the 'loop technique') was introduced in 1999. We assessed the early- and mid-term outcomes for the loop technique in patients with MV prolapse. METHODS: A total of 632 patients (447 male, 185 female) underwent MV repair with Gore-Tex loops for MV prolapse. A mini-thoracotomy was performed in 522 patients (mean age 58+/-12.4 years) and 110 patients received a full sternotomy (mean age 66.5+/-11.9 years). Early postoperative echo was performed in all patients and clinical follow-up was obtained in 95% of patients. RESULTS: Loops were used to correct prolapse of the posterior leaflet in 308 patients, the anterior leaflet in 150 patients, and both leaflets in 174 patients. The mean length of Gore-Tex loops was 20.8+/-3.4 mm for the A2 segment and 14.3+/-3.0mm for the P2 segment. Concomitant procedures consisted of atrial fibrillation ablation in 123 patients, tricuspid valve repair in 30 patients, coronary bypass surgery in 73 patients, and aortic valve surgery in 21 patients. Mean aortic cross-clamp and cardiopulmonary bypass times were 89+/-32 and 137+/-43 min, respectively. Predischarge echocardiography revealed no residual mitral regurgitation (MR) in 75%, trace or mild MR in 21% and mild-to-moderate MR in 4% of patients. Thirty-day survival was 98.6%, and one-year survival was 97.1%. Freedom from reoperation was 97.4+/-1.4%, 3 years postoperatively. CONCLUSION: MV repair with premeasured Gore-Tex loops results in excellent early- and mid-term outcomes for all types of leaflet prolapse. The loop technique facilitates minimal invasive MV repair without compromising surgical outcomes.