A near 100% repair rate for mitral valve prolapse is achievable in a reference center: implications for future guidelines.

摘要: Background Although mitral valve repair is the recommended treatment for severe regurgitation of degenerative etiology, replacement remains common, particularly complex lesions or anterior leaflet involvement. We sought to characterize feasibility and outcomes an "all comers" strategy applied systematically in all cases disease, regardless age, complexity, Methods From January 2002 December 2010, 744 consecutive patients (mean 58 ± 13 years [range, 12-90]; mean LVEF, 55% 9%) with prolapse (anterior leaflet: n=42, 6%; posterior n=556, 75%; bileaflet: n=146, 19%) underwent surgery. Annular, chordal calcification was present 27% cases. Results All received a concomitant annuloplasty median ring size 32 mm (interquartile range, 30-36). There 1 early (99.9% rate) due atrioventricular groove bleeding 5 late re-repairs (0.7%) disease progression infective endocarditis. In-hospital mortality major stroke rates were 0.8% 0.5%, respectively. Survival at 99.2% 0.3% 97.4% 0.8%, Seven-year freedom from reoperation 97.1% 0.6%. The estimate Conclusions A systematic that uses variety techniques allows valves reference center, good short-term mid-term durability. Further study required document long-term efficacy subgroups very morphology.