BACKGROUND: The purpose of this study was to report our 19-year experience in redo surgery for failure of mitral valve repair (MVRep) in degenerative disease. METHODS: From 1987 to 2006, 43 consecutive patients (32 males) underwent either redo MVRep (n = 21) or redo mitral valve replacement (n = 22) for failure of MVRep. Age ranged from 10 to 78 years (median, 59 years). Forty-one patients (95%) had grade 3+ or greater mitral regurgitation, and 3 patients had chronic systolic anterior motion of the anterior leaflet of the mitral valve. Repair was mainly performed using Carpentier's techniques. RESULTS: There was no perioperative death in the MVRep group and 2 deaths in the redo mitral valve replacement group. In univariate analysis, long-term survival was significantly superior in the MVRep group compared with redo mitral valve replacement (p = 0.011). There were three reoperations (14%) in the MVRep group for recurrent severe mitral regurgitation. One patient (5%) in the redo mitral valve replacement group underwent reoperation for prosthetic endocarditis. The 7-year freedom from reoperation rate was 95% (95% confidence interval, 84% to 99%) in both groups. At the latest follow-up, 16 (94%) patients in the MVRep group were in New York Heart Association I or II functional status. Fifteen (88%) had no or mild mitral regurgitation on echocardiography. Two patients (12%) presented with moderate (2+) mitral regurgitation. CONCLUSIONS: In case of failure of MVRep for severe degenerative mitral valve disease, re-repair is feasible in about 50% of the patients with encouraging results at 7 years.
BACKGROUND: The purpose of this study was to report our 19-year experience in redo surgery for failure of mitral valve repair (MVRep) in degenerative disease. METHODS: From 1987 to 2006, 43 consecutive patients (32 males) underwent either redo MVRep (n = 21) or redo mitral valve replacement (n = 22) for failure of MVRep. Age ranged from 10 to 78 years (median, 59 years). Forty-one patients (95%) had grade 3+ or greater mitral regurgitation, and 3 patients had chronic systolic anterior motion of the anterior leaflet of the mitral valve. Repair was mainly performed using Carpentier's techniques. RESULTS: There was no perioperative death in the MVRep group and 2 deaths in the redo mitral valve replacement group. In univariate analysis, long-term survival was significantly superior in the MVRep group compared with redo mitral valve replacement (p = 0.011). There were three reoperations (14%) in the MVRep group for recurrent severe mitral regurgitation. One patient (5%) in the redo mitral valve replacement group underwent reoperation for prosthetic endocarditis. The 7-year freedom from reoperation rate was 95% (95% confidence interval, 84% to 99%) in both groups. At the latest follow-up, 16 (94%) patients in the MVRep group were in New York Heart Association I or II functional status. Fifteen (88%) had no or mild mitral regurgitation on echocardiography. Two patients (12%) presented with moderate (2+) mitral regurgitation. CONCLUSIONS: In case of failure of MVRep for severe degenerative mitral valve disease, re-repair is feasible in about 50% of the patients with encouraging results at 7 years.
Authors: Alison M Pouch; Chun Xu; Paul A Yushkevich; Arminder S Jassar; Mathieu Vergnat; Joseph H Gorman; Robert C Gorman; Chandra M Sehgal; Benjamin M Jackson Journal: J Biomech Date: 2012-01-26 Impact factor: 2.712
Authors: Chun Xu; Arminder S Jassar; Derek P Nathan; Thomas J Eperjesi; Clayton J Brinster; Melissa M Levack; Mathieu Vergnat; Robert C Gorman; Joseph H Gorman; Benjamin M Jackson Journal: Ann Thorac Surg Date: 2012-03-06 Impact factor: 4.330
Authors: Arminder S Jassar; Mathieu Vergnat; Benjamin M Jackson; Jeremy R McGarvey; Albert T Cheung; Giovanni Ferrari; Y Joseph Woo; Michael A Acker; Robert C Gorman; Joseph H Gorman Journal: Ann Thorac Surg Date: 2013-09-23 Impact factor: 4.330