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Mitral valve repair with the edge‐to‐edge technique: A 20 years single‐center experience
Author(s) -
Sideris Konstantinos,
Burri Melchior,
Prinzing Anatol,
Voss Stephanie,
Krane Markus,
Guenzinger Ralf,
Lange Ruediger,
Voss Bernhard
Publication year - 2021
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.15377
Subject(s) - medicine , mitral valve repair , mitral regurgitation , dehiscence , surgery , mitral valve , fibrous joint , cardiology , ejection fraction , heart failure
Objectives For tailored treatment of primary mitral regurgitation (MR), surgeons developed different repair techniques. One of them, the edge‐to‐edge repair has recently seen a revival, especially for Barlow's disease. Methods This study was designed to assess the outcomes of the edge‐to‐edge technique in mitral valve (MV) repair. Preoperative, periprocedural, and postoperative data were prospectively collected in a dedicated database and analyzed retrospectively. Results Between March 1999 and July 2019, a total of 152 patients (mean age: 60 ± 13) received an edge‐to‐edge repair combined with annuloplasty for degenerative MR at our institution. MR resulted from posterior leaflet prolapse in 23 patients (15.1%), anterior leaflet prolapse in 19 (12.5%), and bileaflet prolapse in 110 (72.4%). Of those who had a bileaflet prolapse, 91 (82.7%) had Barlow's disease. Follow‐up was complete in 97.4% (6.4 ± 5.7 years). Echocardiographic assessment was achieved in 85.5% (5.1 ± 5.6 years). Overall survival after 10 years was 73.7 ± 5.0%. Twelve patients required valve‐related reoperations due to ring dehiscence ( n = 2), leaflet suture dehiscence ( n = 2), progression of native valve disease ( n = 6), or due to device failure (ring fracture) ( n = 2). The cumulative incidence of valve‐related reoperation at 10 years was 8.4 ± 3.0% (5.2 ± 4.1% in patients with Barlow's disease). At latest follow‐up, echocardiography revealed excellent valve function with no or mild MR in 93 patients (88.6%). The mean gradient was 2.9 ± 1.3 mmHg at discharge and decreased to 2.4 ± 1.3 mmHg. Three patients (2.8%) had more than moderate MR. Conclusion Edge‐to‐edge MV repair is a simple method with excellent results in terms of valvular function and durability especially in patients with Barlow's disease.