Flere mitralklapper kan bevares ved operation for ikkeiskaemisk mitralklapinsufficiens
Engelsk titel: More native mitral valves can be preserved during non-ischemic mitral valve surgery
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Författare:
Andreasen JJ
;
Tschentscher Espersen G
;
Berning J
Email: jjandreasen@dadlnet.dk
Språk: Dan
Antal referenser: 15
Dokumenttyp:
Artikel
UI-nummer: 05031338
Sammanfattning
Introduction: Newer surgical techniques have been introduced to increase the repair rate of mitral valve surgery in patients with non-ischemic mitral valve insufficiency (MI). This study evaluated the outcomes from the first four years. Materials and methods: Fifty-six patients underwent primary surgery for non-ischemic MI, and mitral valve repair was done on 41 (34 men). The patients' median age was 63 years, range 25-85 years. Degenerative MI was seen in 38 patients. The files and echocardiograms were reviewed retrospectively, and the patients were interviewed. The median clinical follow-up time was two years and eight months. Results: During the period under study, the repair rate increased to 85% among the second half of the patients surveyed. The early mortality rate (<30 days plus mortality in hospital) was 1 of 41 (2.4%). One of five late deaths was valve-related. Preoperatively, 51% of the patients had been in NYHA functional class III or IV. At follow-up, 97% were in NYHA class I. Sixteen patients improved by two or three NYHA classes. Follow-up echocardiograms showed no or trivial MI in 38 of 40 patients. One patient was reoperated on due to endocarditis. The incidence of reoperation was 1.1% per patient-year. The patients' left ventricular dimensions were significantly lower postoperatively. The linearized rate of valve-related complications was 3.2% per patient-year. Discussion: More native mitral valve can be preserved during surgery for non-ischemic mitral valve insufficiency with acceptable results, even in a minor cardiothoracic center.