Key result
Mitral valve plasty significantly enlarged mitral valvular area from 1.65 to 2.51 cm2 and achieved a 97% 3-year survival rate in patients with mitral sclerotic lesions.
Observational (n=38)
No
Mitral valve plasty using combined techniques is a feasible and durable surgical option for elderly patients with mitral sclerotic lesions, significantly improving valve area and reducing regurgitation.
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May support mitral valve plasty in elderly patients with sclerotic lesions; hypothesis-generating and should not change practice without prospective data.
BACKGROUND: Mitral valve repair is preferred over prosthetic replacement. We surgically repaired mitral valve with degenerated sclerotic lesion and demonstrated mid-term results. METHODS: Mitral valve plasty (MVP) was performed with several procedures including ring annuloplasty, leaflet slicing and decalcification. RESULTS: There were 19 males and 19 females with a mean age of 67 ± 12 y.o (n = 38). All patients were successfully treated MVP except one case with unrepairable injuries of the thin leaflet. In patients underwent MVP (n = 37), MVP included ring annuloplasty with a rigid full ring of 32 ± 2 mm (n = 37), leaflet slicing (n = 37), decalcification (n = 15) and artificial chordae (n = 14). Mitral valve area was statistically enlarged by MVP (1.65 ± 0.57 vs 2.51 ± 0.58 cm(2), p < 0.001). Left atrial diameter was statistically reduced after the operation (55 ± 10 vs 46 ± 9 mm, p < 0.001). Severity of MR and right ventricular systolic pressure (RVSP) were statistically decreased after the operation (MR; 1.8 ± 1.0 vs 0.7 ± 0.9, p < 0.001, RVSP; 38 ± 15 vs 30 ± 9 mm Hg, p < 0.001). There were 4 cases with residual MR (Grade II, n = 3; Grade III, n = 1). The 30-days mortality was 0 %. There was one late death due to non-cardiogenic cause (the 3-year survival rate of 97 %) and no redo case due to deterioration of the mitral valve during follow-up period of 21 ± 13 months. CONCLUSIONS: Successful mid-term survival and freedom from reoperation might expect to the durability of MVP in patients with mitral sclerotic lesion.
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Hirota et al. (2016) conducted an observational in Mitral sclerotic lesion (n=38). Mitral valve plasty vs. Preoperative baseline was evaluated on Mitral valvular area (cm2) (p=<0.001). Mitral valve plasty significantly enlarged mitral valvular area from 1.65 to 2.51 cm2 and achieved a 97% 3-year survival rate in patients with mitral sclerotic lesions.
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