Midterm Outcome of Mitral Valve Repair with Artificial Chordae; Comparison between Anterior and Posterior leaflet Prolapse; Single Center Experience
- #AC/VAL 02-O-3
- Adult Cardiac Surgery/Valves. SESSION-2
- Oral
Midterm Outcome of Mitral Valve Repair with Artificial Chordae; Comparison between Anterior and Posterior leaflet Prolapse; Single Center Experience
Sameh Sayed, Dejan Radakovic, Costanaze Bening , Khaled Hamouda, Ina Schade, Veronika Gebhardt, Rainer Leyh, Ivan Aleksic
Cardiothoracic Surgery Department, University of Würzburg , Würzburg , Germany
Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–B
Abstract
Objektives :
Still, few studies report long-term outcomes of anterior mitral leaflet repair using artificial chordae. The aim of this study is to compare our short and mid-term outcomes after anterior and posterior mitral valve repair using chordal replacement and complete leaflet preservation (respect rather than resect approach).
Methods:
Between 2010 and 2014, 174 patients
underwent mitral repair with chordal replacement by expanded polytetrafluroethylene
sutures and leaflet preservation. 55 patients (group 1) had prolapse of the
anterior leaflet compared to 119 patients (group 2) with posterior leaflet
prolapse. Mean age was 64.7±12.4 and 61.5 ±11.8 years in group 1 and 2,
Patient characteristics and co-morbidities were comparable. The
mean number of artificial chordae used/ patient was significantly higher for
anterior leafet repair (3.3±2.4) vs posterior leaflet repair
(2.5±1.2)(p=0.017). Follow up period ranged from 1 to 6 years (mean 33.0±17.3).
Results:
In-hospital mortality was 0.0% and 2.5
% for group 1 and 2 respectively. Early complications was similar in both
groups. There was one late death in
group 1 and 6 late mortalities in group 2( five of them due to non-cardiac
related causes). Kaplan-Meier survival analysis at 3 years was 92% for group 1 and
95% for group 2 (p= 0.40). Four patients in group 1 underwent reoperation for
severe mitral regurgitation in the follow up period versus 12 patients in group
2 (p= 0.760). Freedom from reoperation
was 96% and 94% after 3 years in goup 1 and 2, respectively.
Conclusions:
Anterior leaflet prolapse can be repaired
with chordal replacement and complete leaflet preservation with good early and
midterm results similar to posterior leaflet prolapse. The respect rather than resect approach for
anterior leaflet prolapse is an effective and durable technique for repair.