Surgical repair for degenerative and XXXX . Operative and mid-term results.

@entity1 @entity712 @entity627 @entity339 @entity5 @entity179 @entity1580 @entity884
BACKGROUND: Non randomized studies suggest that mitral valve repair for @entity627 is technically more difficult than repair for @entity179 , and that operative and late results are worse. New surgical techniques have been developed in our and other institutes during the last 5 years, and this moved us to review the experience with these two pathologies and to compare the operative and mid-term RESULTS:                 <AbstractText Label="METHODS" NlmCategory="METHODS">From March 1996 to September 1997, 66 @entity1 underwent primary mitral valve repair for treatment of @entity627 . Fifty-two @entity1 (79%) were in the former group (group A) and 14 in the latter (group B). Surgery was performed by 2 experienced cardiac surgeons. A new technique to calculate the exact artificial chordae length was introduced. In 2 cases, tricuspid autografts were transposed to mitral position and reinforced with artificial chordae. @entity1 were followed both clinically and echocardiographically. The follow-up data were collected in a 1-month period (May 2000). The average clinical follow-up was 3.1+/-0.9 years (range 1.7 to 4.2 years) while the average echocardiographic follow-up was 2.7+/-0.7 years (range 9 months to 4 years). All values were expressed by means of the average and standard deviation. chi(2) and Student's "t"-test were used to analyze the significance between variables. The Kaplan-Meyer method was used for actuarial statistics. RESULTS: There were no operative deaths in either group. In group A, 1 @entity1 underwent a second surgical repair 1 week later, successfully. In group B no @entity1 underwent reoperation within 30 days or during the initial hospitalization. At follow-up of group A there were the following events: deaths from @entity5 (n=2), @entity884 (n=1), @entity1580 (n=1). At follow-up of group B there were mitral valve replacement (1 year after first operation, n=1), Ross procedure (n=1), @entity712 (n=1). Among the remaining 62 @entity1 followed, 32 were in NYHA class I, 15 in class II, 3 in class III, and none in class IV, in group A. In group B, 7 @entity1 were in class I, 4 in class II, 1 in class III and none in class IV (p=ns). In group A @entity339 was absent in 23 @entity1 , mild in 21, moderate in 6, while in group B it was absent in 4, mild in 6, and moderate in 2 (p=ns). In both groups there were no cases of severe insufficiency. The mean gradient was 1.1+/-1.7 mmHg in group A (median=0), and 2.4+/-3.1 mmHg in group B (median=0), (p=ns). No case of systolic anterior movement was seen at mid-term. The event free-survival rate was 92.8% in group A and 92.3% in B. CONCLUSIONS: Perfecting and innovation of surgical techniques make possible nowadays to reach good and equivalent operative and mid-term results in both pathologies.
