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Abstract
Background: Repairing the mitral valve has demonstrated a significant advantage
over managing severe mitral insufficiency over mitral valve replacement. Therefore,
the clinical practice guidelines considered it the first therapeutic option for treating
valvular pathologies. Consequently, it should be widely adopted as a standard
procedure by cardiac surgeons worldwide.
Objective: To establish the reproducibility of mitral valve repair within our hospital in
terms of techniques and outcomes, we aim to compare our performance with data
published by leading international medical institutions. This comparative analysis
will allow us to evaluate our proficiency and quality of care in the field of mitral valve
surgery in line with global standards.
Methods: Between January 2018 and January 2022, 63 patients with severe
mitral insufficiency due to degenerative or functional disease who met surgical
criteria were operated at Luis Vernaza Hospital. Of these, 22 patients underwent
mitral valve repair. We conducted a retrospective longitudinal study and assessed
the postoperative progression, focusing on key outcomes, including valve patency,
reintervention rates, and mortality. The patients’ follow-up was made by telephone
communication, and they underwent at least one annual echocardiogram as a part
of the monitoring process.
Results: As a result, 22 patients (73% males) with an average age of 48 years
(ranging from 36 to 72 years) were analyzed. All patients presented severe mitral
insufficiency, with 91% of cases attributed to primary etiology. In our experience,
severe primary mitral insufficiency was successfully repaired in 55% of cases, with
the P2 segment involvement being the most common cause. On the other hand,
only two patients required reoperation, one due to ring dehiscence and the other
due to rupture of new chordae tendineae. In contrast, we had one case of hospital
mortality associated with immediate reoperation due to repair failure, and three
patients passed away later due to non-cardiovascular causes. Finally, the remaining
patients are asymptomatic, maintain regular activities, have no residual mitral
insufficiency, and maintain a left ventricular function with more than 45% ejection
fraction.
Conclusion: Mitral valve repair with an annuloplasty ring is a technique that can
be successfully replicated in our hospital and provided by cardiac surgeons with
adequate training. This approach yields outcomes similar to those achieved in
globally renowned centers with higher surgical volumes and extensive experience
in mitral valve repairs.
References
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