45 Mitral valve repair – a single centre 10 years experience

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IntroductionMitral valve repair surgery is the procedure of choice for degenerative mitral valve disease in symptomatic patients. There is a paucity of national records in mitral valve repair rates and outcomes in Ireland.AimWe set out to review our mitral valve repair rates for degenerative disease as proposed by the local Heart Team / Joint Cardiology-Cardiac meeting recommendation.MethodA non-randomised retrospective observational study of prospectively collected data from an electronic patient database was conducted over a 10 year period.ResultsThere were a total of 53 mitral valve repair procedures (39 males/14 females; age 64.7± 12.3 years) carried out within a total number of 117 mitral surgical procedures in our unit from 2007 to 2017. Exclusion criteria included mitral stenosis, mitral regurgitation due to ischaemic heart disease, rheumatic valve disease and complex repair procedures involving extensive anterior leaflet pathology or annular calcification. Repair techniques included annuloplasty (96.2%), leaflet ressection (60.3%), neochords implantation (15.1%) and sliding plasty (9.4%). Concommittant procedures included tricuspid valve repair (15%), atrial fibrillation ablation (17%), CABG (5.6%) and AVR (7.5%). There were 2 intraoperative conversions resulting in mitral valve replacement which equates to a 96.2% repair rate among patients considered for mitral valve repair based on heart team recommendations. Clinical and echocardiographic follow-up was achieved in 94.3% of patients. During a median follow up of 63 months there were 2 cardiac deaths. Freedom from mitral regurgitation and reoperation rate were respectively 88.7% and 5.6%.ConclusionMitral valve repair can be carried out with satisfactory short and long-term results in centres with a dedicated interest.

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