Korean J Thorac Cardiovasc Surg.
2003 Dec;36(12):928-936.
Immediate Reoperation for Failed Mitral Valve Repair
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon, Gyeonggi-do, Korea. kubmj@chollian.net
- 2Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, Inje University, Korea.
- 3Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Abstract
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BACKGROUND: We analysed the surgical outcomes of immediate reoperations after mitral valve repair.
MATERIAL AND METHOD: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement.
RESULT: There was no early death. After mean follow-up of 33 months, there was one late death. Echocardiography revealed no or grade I of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78.6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively.
CONCLUSION
This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.
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