Abstract
Aims Ring annuloplasty is the gold standard of surgical repair in degenerative mitral valve disease. However, prosthetic annuloplasty has some drawbacks and potential hazards. Suture annuloplasty theoretically is able to preserve annular leaflet dynamics and left ventricular performance, but experience is limited. The aim of the study was to review the early and long-term outcome of the posterior double-suture annuloplasty (DSA) technique for degenerative mitral valve repair. Methods From January 2002 to December 2008, 400 patients underwent primary mitral valve repair for degenerative disease either with posterior DSA [n=147 (37%)] or with flexible posterior annuloplasty band [n=253 (63%)]. Differences in patient characteristics were addressed by propensity-score matching (132 pairs). A composite end-point of mitral valve failure (MVF) was calculated as the incidence of mitral valve regurgitation greater than 2+ or need for mitral valve replacement at follow-up. Results After propensity-score matching, the distribution of preoperative variables among matched pairs was, on average, equal. Isolated annuloplasty and leaflet repair techniques were similarly performed in both groups (P=0.20). In-hospital mortality was comparable between the two study groups (P=0.48). Predischarge echocardiography showed excellent results regarding valve hemodynamics (P=0.71). At a mean follow-up of 11±3 years, all-cause mortality (P=0.12), need for mitral valve replacement (P=0.49), and cardiac re-hospitalization rate (P=0.57) resulted comparable between the two groups. Ten-year survival (75 vs. 71%, P=0.51) and freedom from MVF (92 vs. 84%, P=0.39) were similar between posterior annuloplasty band and DSA groups. Conclusion Suture annuloplasty demonstrated comparable results with posterior flexible band repair and could be a viable option for mitral valve surgery in selected patients, such as in the minimally invasive approach, in endocarditis, and in developing countries.
| Original language | English |
|---|---|
| Pages (from-to) | 22-26 |
| Number of pages | 5 |
| Journal | Journal of Cardiovascular Medicine |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2018 |
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Keywords
- echocardiography
- mitral valve disease
- mitral valve repair
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Long-term results of suture annuloplasty for degenerative mitral valve disease : A propensity-matched analysis. / Garatti, Andrea; Canziani, Alberto; Parolari, Alessandro; Castelvecchio, Serenella; Guazzi, Marco; Daprati, Andrea; Farah, Ali Abu; Grimaldi, Francesco; Tripepi, Sonia; Menicanti, Lorenzo.
In: Journal of Cardiovascular Medicine, Vol. 19, No. 1, 01.01.2018, p. 22-26.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term results of suture annuloplasty for degenerative mitral valve disease
T2 - A propensity-matched analysis
AU - Garatti, Andrea
AU - Canziani, Alberto
AU - Parolari, Alessandro
AU - Castelvecchio, Serenella
AU - Guazzi, Marco
AU - Daprati, Andrea
AU - Farah, Ali Abu
AU - Grimaldi, Francesco
AU - Tripepi, Sonia
AU - Menicanti, Lorenzo
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Aims Ring annuloplasty is the gold standard of surgical repair in degenerative mitral valve disease. However, prosthetic annuloplasty has some drawbacks and potential hazards. Suture annuloplasty theoretically is able to preserve annular leaflet dynamics and left ventricular performance, but experience is limited. The aim of the study was to review the early and long-term outcome of the posterior double-suture annuloplasty (DSA) technique for degenerative mitral valve repair. Methods From January 2002 to December 2008, 400 patients underwent primary mitral valve repair for degenerative disease either with posterior DSA [n=147 (37%)] or with flexible posterior annuloplasty band [n=253 (63%)]. Differences in patient characteristics were addressed by propensity-score matching (132 pairs). A composite end-point of mitral valve failure (MVF) was calculated as the incidence of mitral valve regurgitation greater than 2+ or need for mitral valve replacement at follow-up. Results After propensity-score matching, the distribution of preoperative variables among matched pairs was, on average, equal. Isolated annuloplasty and leaflet repair techniques were similarly performed in both groups (P=0.20). In-hospital mortality was comparable between the two study groups (P=0.48). Predischarge echocardiography showed excellent results regarding valve hemodynamics (P=0.71). At a mean follow-up of 11±3 years, all-cause mortality (P=0.12), need for mitral valve replacement (P=0.49), and cardiac re-hospitalization rate (P=0.57) resulted comparable between the two groups. Ten-year survival (75 vs. 71%, P=0.51) and freedom from MVF (92 vs. 84%, P=0.39) were similar between posterior annuloplasty band and DSA groups. Conclusion Suture annuloplasty demonstrated comparable results with posterior flexible band repair and could be a viable option for mitral valve surgery in selected patients, such as in the minimally invasive approach, in endocarditis, and in developing countries.
AB - Aims Ring annuloplasty is the gold standard of surgical repair in degenerative mitral valve disease. However, prosthetic annuloplasty has some drawbacks and potential hazards. Suture annuloplasty theoretically is able to preserve annular leaflet dynamics and left ventricular performance, but experience is limited. The aim of the study was to review the early and long-term outcome of the posterior double-suture annuloplasty (DSA) technique for degenerative mitral valve repair. Methods From January 2002 to December 2008, 400 patients underwent primary mitral valve repair for degenerative disease either with posterior DSA [n=147 (37%)] or with flexible posterior annuloplasty band [n=253 (63%)]. Differences in patient characteristics were addressed by propensity-score matching (132 pairs). A composite end-point of mitral valve failure (MVF) was calculated as the incidence of mitral valve regurgitation greater than 2+ or need for mitral valve replacement at follow-up. Results After propensity-score matching, the distribution of preoperative variables among matched pairs was, on average, equal. Isolated annuloplasty and leaflet repair techniques were similarly performed in both groups (P=0.20). In-hospital mortality was comparable between the two study groups (P=0.48). Predischarge echocardiography showed excellent results regarding valve hemodynamics (P=0.71). At a mean follow-up of 11±3 years, all-cause mortality (P=0.12), need for mitral valve replacement (P=0.49), and cardiac re-hospitalization rate (P=0.57) resulted comparable between the two groups. Ten-year survival (75 vs. 71%, P=0.51) and freedom from MVF (92 vs. 84%, P=0.39) were similar between posterior annuloplasty band and DSA groups. Conclusion Suture annuloplasty demonstrated comparable results with posterior flexible band repair and could be a viable option for mitral valve surgery in selected patients, such as in the minimally invasive approach, in endocarditis, and in developing countries.
KW - echocardiography
KW - mitral valve disease
KW - mitral valve repair
UR - http://www.scopus.com/inward/record.url?scp=85039745562&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039745562&partnerID=8YFLogxK
U2 - 10.2459/JCM.0000000000000608
DO - 10.2459/JCM.0000000000000608
M3 - Article
VL - 19
SP - 22
EP - 26
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 1
ER -