Mitral valve reconstruction in Barlow disease: Long-term echographic results and implications for surgical management

被引:39
|
作者
Jouan, Jerome [1 ,2 ]
Berrebi, Alain [1 ,2 ]
Chauvaud, Sylvain [1 ,2 ]
Menasche, Philippe [1 ,2 ,3 ]
Carpentier, Alain [1 ,2 ]
Fabiani, Jean-Noel [1 ,2 ]
机构
[1] Hop Europeen Georges Pompidou, AP HP, Dept Chirurg Cardiovasc, F-75015 Paris, France
[2] Univ Paris 05, Fac Med, Paris, France
[3] Hop Europeen Georges Pompidou, INSERM, UMR 633, F-75015 Paris, France
来源
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY | 2012年 / 143卷 / 04期
关键词
REPAIR; REGURGITATION; DURABILITY;
D O I
10.1016/j.jtcvs.2011.11.016
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Owing to the complexity of the underlying lesions, Barlow disease remains a challenge for surgeons performing mitral valve repair. We aimed to assess whether our most recent results involving several surgeons were comparable with those of a previous experience in which mitral valve repair was performed by a more limited group of surgeons. Methods: From September 2000 to January 2007, 200 patients with Barlow disease (135 men and 65 women; mean age, 56 +/- 13 years) were referred to our institution for surgical treatment of their mitral regurgitation. We retrospectively analysed the mitral lesions characteristics, the surgical techniques used, and clinical outcomes. Follow-up echocardiograms were biannually reviewed. Results: Lesions comprised annular dilatation, excess tissue, and leaflet prolapse in all cases. The most frequent prolapsed segments were P2 (88.5%; n = 177) and A2 (55.5%; n = 111). Annular calcifications and restrictive valvular motion were associated in 20%(n = 40). Repair was feasible in 94.7%(n = 179/189) of non-redo interventions. Immediate postoperative echocardiography showed residual mitral regurgitation greater than 1+ in 6 cases; these patients were all reoperated on within the next months. Operative mortality was 1.5% (n = 3). Mean follow-up was 77.5 +/- 25.6 months. At 8 years postoperatively, overall survival was 88.6% +/- 3.1%, freedom from reintervention was 95.3% +/- 1.7%, and freedom from late recurrent moderate mitral regurgitation (>2+) was 90.2% +/- 3.1% Conclusions: Provided that the fundamental principles of mitral valve reconstruction are respected, the surgical techniques are highly reproducible with good long-term results, similar to those published during the pioneering phase of this surgery. (J Thorac Cardiovasc Surg 2012;143:S17-20)
引用
收藏
页码:S17 / S20
页数:4
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