Mitral valve repair for degenerative disease with leaflet prolapse

To improve long-term outcomes

Takashi Miura, Kiyoyuki Eishi, Siro Yamachika, Koji Hashizume, Kentaro Yamane, Shinichiro Taniguchi, Kazuyoshi Tanigawa, Wataru Hashimoto, Tomohiro Odate, Shun Nakaji

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Residual mitral regurgitation (MR) is a risk factor of reoperation. Here we report the midterm results of mitral valve repair for degenerative disease with mitral valve prolapse and identify important factors for durable repair. Methods: From April 1999 to September 2007, 116 patients with leaflet prolapse (59 men; mean age 63 years) underwent mitral valve repair; they consisted of 19 anterior, 67 posterior, 23 bileaflet, and 7 isolated commissures. The mean clinical and echocardiographic follow-ups were at 4.1 ± 2.3 and 3.3 ± 2.4 years, respectively. Results: Altogether, 12 patients showed recurrent moderate or severe MR during the follow-up period; and 10 of the 12 patients (83.8%) had recurrent moderate or severe MR within 1.5 years. Causes of early MR recurrence were dehiscence of sutured segments and ineffectiveness of the artificial chords. The rates of freedom from reoperation at 3 and 7 years were 95.3% ± 2.0% and 91.0% ± 4.7%, respectively. The rates of freedom from recurrent moderate or severe MR at 3 and 7 years were 90.5% ± 2.9% and 83.8% ± 5.9%, respectively. Conclusions: The prevention of dehiscence of the sutured segment and reestablishment of coaptation using artifi- cial chords are imperative to maintain the durability of mitral valve repair for patients with degenerative disease.

Original languageEnglish (US)
Pages (from-to)10-21
Number of pages12
JournalGeneral Thoracic and Cardiovascular Surgery
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2009

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Prolapse
Mitral Valve Insufficiency
Mitral Valve
Reoperation
Mitral Valve Prolapse
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Miura, Takashi ; Eishi, Kiyoyuki ; Yamachika, Siro ; Hashizume, Koji ; Yamane, Kentaro ; Taniguchi, Shinichiro ; Tanigawa, Kazuyoshi ; Hashimoto, Wataru ; Odate, Tomohiro ; Nakaji, Shun. / Mitral valve repair for degenerative disease with leaflet prolapse : To improve long-term outcomes. In: General Thoracic and Cardiovascular Surgery. 2009 ; Vol. 57, No. 1. pp. 10-21.
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abstract = "Purpose: Residual mitral regurgitation (MR) is a risk factor of reoperation. Here we report the midterm results of mitral valve repair for degenerative disease with mitral valve prolapse and identify important factors for durable repair. Methods: From April 1999 to September 2007, 116 patients with leaflet prolapse (59 men; mean age 63 years) underwent mitral valve repair; they consisted of 19 anterior, 67 posterior, 23 bileaflet, and 7 isolated commissures. The mean clinical and echocardiographic follow-ups were at 4.1 ± 2.3 and 3.3 ± 2.4 years, respectively. Results: Altogether, 12 patients showed recurrent moderate or severe MR during the follow-up period; and 10 of the 12 patients (83.8{\%}) had recurrent moderate or severe MR within 1.5 years. Causes of early MR recurrence were dehiscence of sutured segments and ineffectiveness of the artificial chords. The rates of freedom from reoperation at 3 and 7 years were 95.3{\%} ± 2.0{\%} and 91.0{\%} ± 4.7{\%}, respectively. The rates of freedom from recurrent moderate or severe MR at 3 and 7 years were 90.5{\%} ± 2.9{\%} and 83.8{\%} ± 5.9{\%}, respectively. Conclusions: The prevention of dehiscence of the sutured segment and reestablishment of coaptation using artifi- cial chords are imperative to maintain the durability of mitral valve repair for patients with degenerative disease.",
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Miura, T, Eishi, K, Yamachika, S, Hashizume, K, Yamane, K, Taniguchi, S, Tanigawa, K, Hashimoto, W, Odate, T & Nakaji, S 2009, 'Mitral valve repair for degenerative disease with leaflet prolapse: To improve long-term outcomes', General Thoracic and Cardiovascular Surgery, vol. 57, no. 1, pp. 10-21. https://doi.org/10.1007/s11748-008-0330-z

Mitral valve repair for degenerative disease with leaflet prolapse : To improve long-term outcomes. / Miura, Takashi; Eishi, Kiyoyuki; Yamachika, Siro; Hashizume, Koji; Yamane, Kentaro; Taniguchi, Shinichiro; Tanigawa, Kazuyoshi; Hashimoto, Wataru; Odate, Tomohiro; Nakaji, Shun.

In: General Thoracic and Cardiovascular Surgery, Vol. 57, No. 1, 01.01.2009, p. 10-21.

Research output: Contribution to journalArticle

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T1 - Mitral valve repair for degenerative disease with leaflet prolapse

T2 - To improve long-term outcomes

AU - Miura, Takashi

AU - Eishi, Kiyoyuki

AU - Yamachika, Siro

AU - Hashizume, Koji

AU - Yamane, Kentaro

AU - Taniguchi, Shinichiro

AU - Tanigawa, Kazuyoshi

AU - Hashimoto, Wataru

AU - Odate, Tomohiro

AU - Nakaji, Shun

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Purpose: Residual mitral regurgitation (MR) is a risk factor of reoperation. Here we report the midterm results of mitral valve repair for degenerative disease with mitral valve prolapse and identify important factors for durable repair. Methods: From April 1999 to September 2007, 116 patients with leaflet prolapse (59 men; mean age 63 years) underwent mitral valve repair; they consisted of 19 anterior, 67 posterior, 23 bileaflet, and 7 isolated commissures. The mean clinical and echocardiographic follow-ups were at 4.1 ± 2.3 and 3.3 ± 2.4 years, respectively. Results: Altogether, 12 patients showed recurrent moderate or severe MR during the follow-up period; and 10 of the 12 patients (83.8%) had recurrent moderate or severe MR within 1.5 years. Causes of early MR recurrence were dehiscence of sutured segments and ineffectiveness of the artificial chords. The rates of freedom from reoperation at 3 and 7 years were 95.3% ± 2.0% and 91.0% ± 4.7%, respectively. The rates of freedom from recurrent moderate or severe MR at 3 and 7 years were 90.5% ± 2.9% and 83.8% ± 5.9%, respectively. Conclusions: The prevention of dehiscence of the sutured segment and reestablishment of coaptation using artifi- cial chords are imperative to maintain the durability of mitral valve repair for patients with degenerative disease.

AB - Purpose: Residual mitral regurgitation (MR) is a risk factor of reoperation. Here we report the midterm results of mitral valve repair for degenerative disease with mitral valve prolapse and identify important factors for durable repair. Methods: From April 1999 to September 2007, 116 patients with leaflet prolapse (59 men; mean age 63 years) underwent mitral valve repair; they consisted of 19 anterior, 67 posterior, 23 bileaflet, and 7 isolated commissures. The mean clinical and echocardiographic follow-ups were at 4.1 ± 2.3 and 3.3 ± 2.4 years, respectively. Results: Altogether, 12 patients showed recurrent moderate or severe MR during the follow-up period; and 10 of the 12 patients (83.8%) had recurrent moderate or severe MR within 1.5 years. Causes of early MR recurrence were dehiscence of sutured segments and ineffectiveness of the artificial chords. The rates of freedom from reoperation at 3 and 7 years were 95.3% ± 2.0% and 91.0% ± 4.7%, respectively. The rates of freedom from recurrent moderate or severe MR at 3 and 7 years were 90.5% ± 2.9% and 83.8% ± 5.9%, respectively. Conclusions: The prevention of dehiscence of the sutured segment and reestablishment of coaptation using artifi- cial chords are imperative to maintain the durability of mitral valve repair for patients with degenerative disease.

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