Several new considerations in mitral valve repair.

摘要: BACKGROUND AND AIM OF THE STUDY A retrospective evaluation was made of a small personal series patients undergoing mitral valve repair in order to address four contemporary questions: (i) What is the best method achieving stable prolapse?; (ii) How should with pure annular dilatation without prolapse or antecedent ischemia be categorized?; (iii) Are procedures ischemic regurgitation (MR) still associated less satisfactory early and late outcomes?; (iv) Is prophylactic amiodarone therapy safe effective reducing postoperative arrhythmias? METHODS Between 1993 2002, total 118 non-rheumatic MR isolated coronary bypass analyzed retrospectively: these patients, 66 had (Group I), 21 II), 31 III). All three groups routinely underwent Carpentier ring annuloplasty. Twenty-three Group I were managed leaflet resection reconstruction (LRR), but 1996 technique for changed uniform artificial chordal replacement (ACR) no (n = 43). Also 1996, first used routinely, arrhythmia data compared those from prior patients. Baseline outcome variables assessed each group between groups. Survival evaluated using Cox proportional hazards model. RESULTS Significant differences baseline characteristics observed: II predominantly female; III more often experienced acute presentation; Groups comorbid disorders left ventricular dysfunction (all p 0.10). model analysis nine years follow up (median 4 years) identified only advanced age number comorbidities as influencing mortality (both < 0.03). Over period, 8.7% LRR required reoperation failure due rupture, whereas none ACR failed. Finally, significantly reduced arrhythmias (p 0.03) observed complications, also eliminated death arrhythmia. CONCLUSION Ischemic etiology may diminishing an independent risk factor III, at least partially because repair. comprised distinct entity females higher comorbidity, seemed useful routine measure. appeared produce virtually all suggesting that might appropriately annuloplasty ACR. However, future studies are suggested further consideration hypotheses.