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Surgical outcomes of mitral valve replacement with concomitant mitral annular reconstruction
Author(s) -
Kim Su Wan,
Jeong Dong Seop,
Sung Kiick,
Kim Wook Sung,
Lee Young Tak,
Park Pyo Won
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13542
Subject(s) - medicine , endocarditis , mitral valve replacement , ejection fraction , mitral valve , cardiology , surgery , concomitant , calcification , infective endocarditis , heart failure
Background and aim of the study We evaluated the early and long‐term outcomes of mitral annular reconstruction (MAR) with pericardium during mitral valve replacement (MVR), and analyzed the risk factors associated with post‐operative mortality. Methods Between May 1997 and April 2013, 78 consecutive patients underwent MVR with MAR. The indications for MAR were treatment for annular infection in native valve endocarditis (n = 23, 29.5%) or prosthetic valve endocarditis (n = 26, 33.3%), reinforcement of damaged annulus resulting from a previous operation (n = 17, 21.8%), complete excision of extensive calcification (n = 9, 11.5%), and left ventricular or left atrial rupture (n = 3, 3.8%). Patients were classified into infective endocarditis (n = 49) and non‐endocarditis groups (n = 29). The mean follow‐up period was 59.4 ± 47.3 months. Results There were two operative deaths and 11 cases of late mortality in the endocarditis group and five cases in the non‐endocarditis group. Late prosthetic valve endocarditis occurred in four patients. The overall survival rate at 1 and 10 years was 94.8% and 65.1%, respectively. There was no statistical difference in the overall survival, freedom from reoperation, and freedom from endocarditis rates between the groups ( P = 0.565, P = 0.635, and P = 0.449, respectively). Univariable and multivariable analyses revealed that pre‐operative left ventricular dysfunction (ejection fraction <40%) was an independent predictor of overall mortality. Conclusions The early and long‐term results of MAR with pericardium during MVR are acceptable in both endocarditis and non‐endocarditis patients.