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Ali Refatllari

University Hospital Centre “Mother Theresa”, Tirana, Albania

Title: The early and midterm results of mitral valve repair surgery

Biography

Biography: Ali Refatllari

Abstract

Background: Mitral valve repair in patients with mitral valve regurgitation is associated with an improved quality of life with less morbidity as well as better long-term survival as opposed to replacement. We assessed  the characteristics and outcome of patients treated with conservative mitral surgery in our centers. 

Methods and Materials: We considered for enrollment in this study 62  patients with mitral valve disease who underwent mitral valve repair for moderate to severe mitral regurgitation, in two hospitals between January 2009 and December 2012. Patients who underwent concomitant surgery for other conditions were also included. 34 patients (55%) were men. Mean age was 57.5+-12.5 years.  The primary outcome of interest was death, mitral residual regurgitation and need for reintervention. On admission, 79 % of the patients had heart failure NYHA III-IV. Severe mitral regurgitation was present in 40 (64.5%)patients. Median sternotomy was surgical aproach, using moderate hypotermia during bypass time. Surgical techniques used were implantation of a prosthetic ring in 95.2 %, quadrangular resection of posterior leaflet in 19.4%, cordal replacement in 6.5%, mitral commissurotomy in 14.5%, cordal transfer in 8%, Alfieri stich in 4.8% of patients. Patients were followed up for 1 and 6 months after the mitral surgical procedure. Evaluation of mitral valve repair is based in transthoracal and transesophageal echocardiographic examinations.

Results: No deaths in early postoperative period. Early after surgery, 58 % of patients had no mitral regurgitation, 34% had mild mitral regurgitation; only one patient had moderate mitral regurgitation. After one month, only 1 (1.8%) patient had more than  moderate mitral regurgitation.At six month follow-up only 2 (4%) patients had more than moderate mitral regurgitation. There were no deaths or reinterventions during 6-month follow up. 

Conclusion: Mitral valve repair for mitral regurgitation  has been associated with  good short to midterm results.