Key result
Mitral valve repair in patients with bileaflet prolapse demonstrated good durability with a 4.5% mortality rate, 1.1% reoperation rate, and 1.1% rate of recurrent severe mitral insufficiency over a mean follow-up of 25.3 months.
Why the study?
Most surgeons hesitate to perform mitral valve repair in patients with bileaflet prolapse, prompting evaluation of postoperative outcomes with repair techniques in this population.
Does mitral valve repair improve clinical and echocardiographic outcomes in patients with mitral valve insufficiency due to bileaflet prolapse?
Cohort (n=89)
No
Does mitral valve repair improve clinical and echocardiographic outcomes in patients with mitral valve insufficiency due to bileaflet prolapse?
Mitral valve repair for bileaflet prolapse yields good mid-term durability, significant improvements in functional capacity, and favorable reverse remodeling.
Supports mid-term durability of repair in bileaflet prolapse; leaves open need for randomized confirmation.
Background Today, repair techniques almost completely take place of the mitral valve replacement, especially in patients with degenerative disease. Majority of the surgeons hesitate to prefer repair in patients with bileaflet prolapse. In this study we aimed to investigate postoperative results of our patients with mitral valve insufficiency due to bileaflet prolapse and treated with repair techniques Methods 89 patients who underwent mitral valve repair by the same surgical team due to bileaflet prolapse, between January 2006 and January 2016 in Turkiye Yuksek Ihtisas Hospital were included to this study. Preoperative, operative and postoperative data such as mortality, recurrent mitral insufficiency, echocardiographic parameters and reoperation rates were investigated. Results Mean follow up duration was 25.3±17.7 months. Mean age was 46.6±17.4 years. According to the transthoracic echocardiographic evaluations, 8 (9%) patients had moderate and 81 (91%) patients had severe mitral insufficiency. When preoperative and postoperative values were compared statistically significant improvement in functional capacity of patients according to NYHA classification has been noted. (2.1±0.5 ; 1, , p=0.001) Improvements in left ventricular end diastolic diameter (5.5±0.7 cm ; 5±0.6 cm, p=0.001), left ventricular end sistolic diameter (3.8±0.6 cm ; 3.6±0.6 cm, p=0.004 ), left atrium diameter (4.8±0.9 cm ; 4.3±0.6 cm, p=0.001) and pulmonary artery pressure (44.3±13.4 mmHg; 32.1±5.4 mmHg, p=0.001) were statistically significant. Conclusions In the lights of findings about good postoperative results and durability rates, mitral valve repair can be safely used in patients with mitral valve insufficiency due to bileaflet prolapse especially with chordae replacement technique which can be feasible after improvements in suture technologies.
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Günertem et al. (2023) conducted a cohort in Mitral valve insufficiency due to bileaflet prolapse (n=89). Mitral valve repair vs. Preoperative baseline was evaluated on Development of severe mitral insufficiency, reoperation, and mortality. Mitral valve repair in patients with bileaflet prolapse demonstrated good durability with a 4.5% mortality rate, 1.1% reoperation rate, and 1.1% rate of recurrent severe mitral insufficiency over a mean follow-up of 25.3 months.
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