Key result
Edge-to-edge mitral valve repair combined with annuloplasty for degenerative mitral regurgitation yielded an overall survival of 73.7% and a valve-related reoperation incidence of 8.4% at 10 years.
Why the study?
The edge-to-edge repair technique has recently seen a revival for tailored treatment of primary MR, especially for Barlow disease, but its outcomes needed assessment.
Cohort (n=152)
No
Surgical edge-to-edge mitral valve repair combined with annuloplasty provides excellent long-term durability and valve function, particularly for patients with Barlow's disease.
Answers are grounded in this paper and cite their sources.
May inform surgical choices for durable mitral repair in selected patients; leaves open need for randomized comparisons to alternatives.
OBJECTIVES: For tailored treatment of primary mitral regurgitation (MR), surgeons developed different repair techniques. One of them, the edge-to-edge repair has recently seen a revival, especially for Barlow's disease. METHODS: This study was designed to assess the outcomes of the edge-to-edge technique in mitral valve (MV) repair. Preoperative, periprocedural, and postoperative data were prospectively collected in a dedicated database and analyzed retrospectively. RESULTS: Between March 1999 and July 2019, a total of 152 patients (mean age: 60 ± 13) received an edge-to-edge repair combined with annuloplasty for degenerative MR at our institution. MR resulted from posterior leaflet prolapse in 23 patients (15.1%), anterior leaflet prolapse in 19 (12.5%), and bileaflet prolapse in 110 (72.4%). Of those who had a bileaflet prolapse, 91 (82.7%) had Barlow's disease. Follow-up was complete in 97.4% (6.4 ± 5.7 years). Echocardiographic assessment was achieved in 85.5% (5.1 ± 5.6 years). Overall survival after 10 years was 73.7 ± 5.0%. Twelve patients required valve-related reoperations due to ring dehiscence (n = 2), leaflet suture dehiscence (n = 2), progression of native valve disease (n = 6), or due to device failure (ring fracture) (n = 2). The cumulative incidence of valve-related reoperation at 10 years was 8.4 ± 3.0% (5.2 ± 4.1% in patients with Barlow's disease). At latest follow-up, echocardiography revealed excellent valve function with no or mild MR in 93 patients (88.6%). The mean gradient was 2.9 ± 1.3 mmHg at discharge and decreased to 2.4 ± 1.3 mmHg. Three patients (2.8%) had more than moderate MR. CONCLUSION: Edge-to-edge MV repair is a simple method with excellent results in terms of valvular function and durability especially in patients with Barlow's disease.
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Sideris et al. (2021) conducted a cohort in Degenerative mitral regurgitation (n=152). Edge-to-edge mitral valve repair combined with annuloplasty was evaluated on Overall survival after 10 years. Edge-to-edge mitral valve repair combined with annuloplasty for degenerative mitral regurgitation yielded an overall survival of 73.7% and a valve-related reoperation incidence of 8.4% at 10 years.
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