Key result
Re-repair for late posterior failure of mitral valve repair was feasible in 69% of patients, with no perioperative mortality and good functional outcomes at a median follow-up of 105 months.
Why the study?
Is re-repair feasible and effective for patients with late posterior failure of a previous mitral valve repair in degenerative disease?
Observational (n=13)
Is re-repair feasible and effective for patients with late posterior failure of a previous mitral valve repair in degenerative disease?
Answers are grounded in this paper and cite their sources.
Re-repair for late posterior failure of mitral valve repair in degenerative disease is feasible in the majority of patients and yields encouraging long-term clinical and echocardiographic outcomes.
OBJECTIVES: Little is known regarding the mechanisms, the feasibility and the long-term results of re-repair in 'posterior failure' of a previous mitral valve repair performed for severe degenerative mitral regurgitation. We report our 16-year experience in redo surgery for late posterior failure of mitral valve repair in degenerative disease. METHODS: From 1991 to 2004, 13 consecutive patients (10 males; median age: 65 years) were reoperated for late posterior failure of mitral valve repair. All patients had grade > or =3+ mitral regurgitation. Repair was mainly performed using Carpentier's techniques. RESULTS: Repair failure was due to posterior leaflet prolapse, leaflet retraction or leaflet dehiscence in eight (62%), three (23%) and two (15%) patients, respectively. Repair was performed in nine patients (69%). There was no perioperative death. During follow-up (median: 105 months; range: 40-170 months) one late death occurred in the mitral valve replacement group. One (11%) patient underwent mechanical mitral valve replacement 125 months after re-repair. Congestive heart failure occurred in one patient in each group. At the latest follow-up, all but one patient in the mitral valve repair group were in NYHA functional class I or II and all were in sinus rhythm. Doppler echocardiographic studies of the re-repaired valves (n=8) showed no or trivial, grade 1+ and grade 2+ residual mitral regurgitation in 6 (75%), 1 and 1 patients, respectively. Mean transmitral gradient was 3 mmHg (2-8 mmHg) and left ventricular ejection fraction was 59% (43-77%). CONCLUSION: In case of late posterior failure of mitral valve repair for severe degenerative, re-repair is feasible in about 70% of the patients with encouraging results at 10 years.
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Zegdi et al. (2008) conducted an observational in Late posterior failure of mitral valve repair in degenerative disease (n=13). Redo surgery (re-repair) was evaluated on Feasibility and long-term results (survival, NYHA class, residual MR). Re-repair for late posterior failure of mitral valve repair was feasible in 69% of patients, with no perioperative mortality and good functional outcomes at a median follow-up of 105 months.
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