Causes of repair failure for degenerative mitral valve disease and reoperation outcomes

Hidefumi Nishida, Toshihiro Fukui, Hitoshi Kasegawa, Hajime Kin, Masataka Yamazaki, Shuichiro Takanashi

研究成果: Article査読

11 被引用数 (Scopus)

抄録

OBJECTIVES: This study aimed to evaluate the causes of initial mitral valve (MV) repair failure, the details of reoperation and the longterm outcomes of mitral valve re-repair (Re-MVP). METHODS: We retrospectively reviewed 86 patients who underwent reoperation after MV repair for MR due to degenerative disease from October 1991 to December 2015. First, we analysed the initial MV repair data, causes of MV repair failure, reoperation data and long-term outcomes including survival. Second, the patients were classified into 2 groups based on valve related failure or procedure related failure, and the differences between the groups were analysed. RESULTS: Leaflet prolapse at the initial operation affected the bilateral leaflets in 37 (43%) patients, the anterior leaflet in 30 (35%) patients and the posterior leaftlet in 19 (22%) patients. Median duration from first operation to reoperation was 47.5 (interquartile range 4.8- 85.8) months. Reoperation indication included recurrent mitral regurgitation alone in 59 patients, haemolysis combined with recurrent mitral regurgitation in 15 patients, infectious endocarditis combined with recurrent mitral regurgitation in 8 patients, mitral stenosis in 2 patients and left ventricular pseudoaneurysm in 2 patients. The cause of MV repair failure was valve-related in 61 (71%) patients, procedure- related in 20 (23%) patients and both in 5 (6%) patients. Re-MVP was successful in 23 (27%) patients. Re-MVP was more common in patients with procedure-related failure, which occurred earlier than valve-related failure. Freedom from all-cause death was significantly better after Re-MVP. The 5-year freedom from reoperation after Re-MVP was 95.7%. CONCLUSIONS: Re-MVP was more common in patients with procedure-related failure, which occurred earlier than valve-related failure. Durability of re-repaired MVs and survival of re-repaired patients were acceptable.

本文言語English
ページ(範囲)1244-1250
ページ数7
ジャーナルEuropean Journal of Cardio-thoracic Surgery
53
6
DOI
出版ステータスPublished - 2018 6 1
外部発表はい

ASJC Scopus subject areas

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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