Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años

Background: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. Aim: To assess the probability of success, op...

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Autores principales:	Latorre S,Gonzalo, Almeida Z,Josefina, Besa B,Santiago, Córdova A,Samuel, Zalaquett S,Ricardo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2015
Materias:	Cardiac surgical procedures Mitral valve Mitral valve annuloplasty Mitral valve insufficiency
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015001000001
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spelling	oai:scielo:S0034-988720150010000012015-12-03Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 añosLatorre S,GonzaloAlmeida Z,JosefinaBesa B,SantiagoCórdova A,SamuelZalaquett S,Ricardo Cardiac surgical procedures Mitral valve Mitral valve annuloplasty Mitral valve insufficiency Background: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. Aim: To assess the probability of success, operative mortality and long-term results of MVR for DMI. Patients and Methods: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013. Long-term survival information was obtained from death certificate records of the Chilean Identification Service. Results: One hundred forty seven patients with DMI were identified, all operated by one author (RZ). In 28 (19%) the mitral valve was replaced, including three patients in whom a MVR was intended without success. A successful MVR was performed in 119 patients (81%). The probability of a successful MVR was 97.5% (119 of 122). Prolapsed posterior leaflet was present in 81% and annulus dilatation in 60% of cases. The most frequent surgical procedures were quadrilateral resection (83%) and chordal transfer (13%). A mitral annuloplasty was performed in 92% of cases. Operative mortality was 0.8%. At the end of a 9.9 (0 - 22.7) years follow-up, 87 patients (73%) were alive and mean survival was 16.9 years. Survival rates at 5, 10, 15 and 20 years were 91%, 78%, 71% and 50%, respectively. Six patients were re-operated, due to mitral valve dysfunction in three. Mean re-operation free survival was 21.4 years. Echocardiographic follow-up was 75% completed at an average of 64 months; 84% of cases had no or only 1+ mitral regurgitation. Conclusions: In our experience, MVR for DMI had an operative mortality below 1% and a probability of success greater than 95%, with excellent long-term results.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.143 n.10 20152015-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015001000001es10.4067/S0034-98872015001000001
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Cardiac surgical procedures Mitral valve Mitral valve annuloplasty Mitral valve insufficiency
spellingShingle	Cardiac surgical procedures Mitral valve Mitral valve annuloplasty Mitral valve insufficiency Latorre S,Gonzalo Almeida Z,Josefina Besa B,Santiago Córdova A,Samuel Zalaquett S,Ricardo Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
description	Background: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. Aim: To assess the probability of success, operative mortality and long-term results of MVR for DMI. Patients and Methods: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013. Long-term survival information was obtained from death certificate records of the Chilean Identification Service. Results: One hundred forty seven patients with DMI were identified, all operated by one author (RZ). In 28 (19%) the mitral valve was replaced, including three patients in whom a MVR was intended without success. A successful MVR was performed in 119 patients (81%). The probability of a successful MVR was 97.5% (119 of 122). Prolapsed posterior leaflet was present in 81% and annulus dilatation in 60% of cases. The most frequent surgical procedures were quadrilateral resection (83%) and chordal transfer (13%). A mitral annuloplasty was performed in 92% of cases. Operative mortality was 0.8%. At the end of a 9.9 (0 - 22.7) years follow-up, 87 patients (73%) were alive and mean survival was 16.9 years. Survival rates at 5, 10, 15 and 20 years were 91%, 78%, 71% and 50%, respectively. Six patients were re-operated, due to mitral valve dysfunction in three. Mean re-operation free survival was 21.4 years. Echocardiographic follow-up was 75% completed at an average of 64 months; 84% of cases had no or only 1+ mitral regurgitation. Conclusions: In our experience, MVR for DMI had an operative mortality below 1% and a probability of success greater than 95%, with excellent long-term results.
author	Latorre S,Gonzalo Almeida Z,Josefina Besa B,Santiago Córdova A,Samuel Zalaquett S,Ricardo
author_facet	Latorre S,Gonzalo Almeida Z,Josefina Besa B,Santiago Córdova A,Samuel Zalaquett S,Ricardo
author_sort	Latorre S,Gonzalo
title	Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
title_short	Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
title_full	Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
title_fullStr	Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
title_full_unstemmed	Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
title_sort	reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años
publisher	Sociedad Médica de Santiago
publishDate	2015
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015001000001
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Reparación valvular mitral en insuficiencia mitral degenerativa: reparabilidad, resultados inmediatos y seguimiento hasta 20 años

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