Impact of Timing and Surgical Approach on Outcomes After Mitral Valve Regurgitation Operations

摘要: Background This study investigated whether the timing of mitral valve (MV) repair or surgical approach affects outcomes in patients with MV regurgitation. Methods Between 1992 and 2009, 2,255 underwent operations, including 1,305 isolated regurgitation operations (1,054 repairs, 251 replacements). Surgical approaches were sternotomy 377, video-assisted right minithoracotomy 481, robot-assisted 447. Mean follow-up was 6.4 ± 4.5 years (maximum, 19 years). Results Sternotomy repairs decreased during while minimally invasive increased. Robotic younger, fewer women, had better left ventricular ejection fractions, more likely to have myxomatous degeneration (all p = 0.409). Fewer neurological events observed videoscopic robotic groups ( 0.013). Adjusted survival similar for all 0.357). Survival New York Heart Association class I II annular dilatation a matched population but worse III IV undergoing replacement. Conclusions severe should be performed before symptoms develop. Minimally techniques render as approach.