Repair of Complex Mitral Valve Pathologies: Is It Worth to Cope With?

Abstract

Introduction: Mitral valve (MV) repair is preferred over replacement for its benefits of preservation ofventricular function, lower operative mortality, superior long-term survival, and avoidance of anticoagulation.In this study, we aimed to review the repair techniques of complex MV pathologies and their outcomes.Patients and Methods: We retrospectively analyzed 56 patients (mean age 41.8 ± 16.5 years; 33 males)who underwent repair of complex MV pathologies. 44 patients had pure mitral regurgitation (MR), and 12(21.4%) had mixed mitral disease (mitral stenosis (MS) + MR). Preoperative and operative characteristics,postoperative MR severity, operative mortality, and midterm survival were examined for each patient.Results: There was only one early death (30-day mortality: 1.8%) due to postoperative low cardiacoutput syndrome. The procedures were successful in all patients who underwent MV repair. Transthoracicechocardiography examinations revealed no/trivial MR in 74.6% and mild MR in 21.8% of patients atdischarge. Late follow-up was obtained in 55 patients. The mean follow-up period of patients was 47.9 ± 23.1months. Mortality developed in one (1.8%) patient with Marfan syndrome who had acute aortic dissectionthree years after MV surgery. During follow-up visits, mitral repair procedures were successful in 49 (90.7%)patients. Four (7.4%) patients presented with moderate MR. Only one (1.9%) patient needed reoperationbecause of severe MR.Conclusion: This study showed that repair of complex MV pathologies provides excellent surgical outcomes.Repair of complex MV pathologies is safe and highly effective, but operations require considerable surgicalexperience.