Key result
The edge-to-edge technique significantly reduced residual mitral regurgitant jet area from 3.0 cm2 to 0.7 cm2 (P=0.00014) when used to rescue imperfect conventional mitral valve repair.
Why the study?
Does the edge-to-edge technique reduce residual mitral insufficiency in patients with an imperfect conventional mitral valve repair?
Observational (n=108)
Does the edge-to-edge technique reduce residual mitral insufficiency in patients with an imperfect conventional mitral valve repair?
The edge-to-edge technique provides a rapid and effective intraoperative rescue strategy for imperfect conventional mitral valve repair, significantly reducing residual mitral regurgitation.
May support edge-to-edge rescue for residual MR; hypothesis-generating and should not yet change practice.
OBJECTIVE: The edge-to-edge (E-to-E) technique in mitral valve repair (MVR) is promising especially to correct mitral insufficiency (MI) caused by complex mitral valve lesions. We tested this technique to improve residual MI straight after conventional MVR. METHODS: From September 1998 to January 2002, 108 consecutive patients underwent MVR with current techniques for pure MI. Intraoperative transesophageal echocardiography was performed before and after MVR. At the end of cardiopulmonary bypass (CPB), 11 patients presented residual mitral regurgitant jet area (MRA) > or =2.0 cm(2). The E-to-E technique was used to improve this residual MI, without taking-down the original MVR. RESULTS: There were no hospital deaths. One patient died of non-valve-related cardiac death about 6 months after hospital discharge. At intraoperative ecocardiography, residual MRA improved from 3.0 +/- 0.8 cm(2), after conventional MVR, to 0.7 +/- 0.9 cm(2), after the E-to-E technique (P = 0.00014). Additional CPB time of 14.9 +/- 2.8 min was needed. These echocardiographic results were confirmed at follow-up of 13.8 +/- 8.1 months. CONCLUSIONS: The E-to-E technique is a simple, rapid, effective, and durable option to reduce residual MI and rescue an imperfect conventional MVR.
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Gatti et al. (2002) conducted an observational in pure mitral insufficiency (n=108). Edge-to-edge (E-to-E) technique vs. Conventional mitral valve repair (before E-to-E) was evaluated on residual mitral regurgitant jet area (MRA) (p=0.00014). The edge-to-edge technique significantly reduced residual mitral regurgitant jet area from 3.0 cm2 to 0.7 cm2 (P=0.00014) when used to rescue imperfect conventional mitral valve repair.
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