Key result
Mitral valve repair improves long-term outcomes over replacement in regurgitant disease by avoiding prosthesis-related complications.
Why the study?
Long-term outcomes for patients undergoing mitral valve repair are superior to those undergoing replacement, but detailed knowledge of repair techniques is required for durable results.
Does mitral valve repair improve long-term outcomes compared to mitral valve replacement in patients with regurgitant mitral valve disease?
Does mitral valve repair improve long-term outcomes compared to mitral valve replacement in patients with regurgitant mitral valve disease?
Mitral valve repair is the preferred surgical approach over replacement for regurgitant disease due to superior long-term outcomes and avoidance of anticoagulation.
Established mitral repair techniques remain standard; extends 50-year evolution while leaving comparative durability open for trials.
PURPOSE OF REVIEW: To review the evolution of mitral valve repair and outline currently favored repair techniques. RECENT FINDINGS: Chordal replacement with polytetrafluoroethylene sutures is an accepted and reproducible technique for repair of the anterior leaflet. Most posterior leaflet problems can be addressed with either a quadrangular resection or a sliding repair. SUMMARY: Mitral valve surgery has gradually evolved over the period of the last 50 years. Initially, most surgeons replaced the mitral valve in patients with regurgitant disease. It is now known, however, that long-term outcome for patients undergoing repair is superior to that for patients undergoing replacement. Mitral valve repair avoids the complications associated with the artificial valve and anticoagulation. The ability to reproducibly repair the mitral valve requires a detailed knowledge of the disease process and the reparative techniques. This article describes the current approach to mitral valve surgery and the important concepts necessary to achieve a durable repair.
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Walkes et al. (2004) conducted a review in Mitral valve regurgitant disease. Mitral valve repair vs. Mitral valve replacement was evaluated. Mitral valve repair provides superior long-term outcomes compared to replacement for patients with regurgitant disease by avoiding complications associated with artificial valves and anticoagulation.
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