Why the study?
To determine repair durability and survival in patients with and without connective tissue disorders undergoing concomitant aortic valve reimplantation and mitral valve repair.
Does concomitant aortic valve reimplantation and mitral valve repair provide durable repair and survival in patients with severe degenerative mitral regurgitation and aneurysmal aortic root disease?
Does concomitant aortic valve reimplantation and mitral valve repair provide durable repair and survival in patients with severe degenerative mitral regurgitation and aneurysmal aortic root disease?
Concomitant aortic valve reimplantation and mitral valve repair is a safe and durable strategy for patients with degenerative mitral regurgitation and aneurysmal aortic root disease, yielding excellent long-term survival and freedom from reoperation.
Supports durability of concomitant aortic-mitral repair at 10 years regardless of Marfan status; extends observational data but leaves open need for randomized confirmation.
Objective: The study objective was to determine repair durability and survival in patients with and without connective tissue disorders undergoing concomitant aortic valve reimplantation and mitral valve repair. Methods: From 2002 to 2019, 68 patients underwent concomitant aortic valve reimplantation and mitral valve repair, including 27 patients with Marfan syndrome (39.7%). Follow-up echocardiograms were analyzed using nonlinear multiphase mixed-effects cumulative logistic regression. The regurgitation grade over time was estimated by averaging patient-specific profiles. Survival and freedom from reoperation were estimated by the Kaplan-Meier method. Results: = .04). Freedom from reoperation on the aortic valve or mitral valve was 83% at 10 years and did not differ between Marfan syndrome groups. There were no cases of perioperative mortality. Survival at 5 and 10 years was 94% and 87%, respectively, without a difference between those with and without Marfan syndrome. Conclusions: Patients can undergo a total repair strategy using combined aortic valve reimplantation and mitral valve repair procedures with a low risk of mortality and complications, with favorable freedom from both residual valve regurgitation and reoperation.
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Burns et al. (2023) studied this question.
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