Mitral valve repair: beyond the French correction.
BACKGROUND
We analysed retrospectively patients who underwent mitral valve repair using techniques beyond the "French correction", as popularised by Carpentier.


METHODS
From June 1997 to June 2006, 153 patients underwent mitral valve repair. Their mean age was 63.1 +/- 13.5 years (range 19-87). Mean Euroscore was 4.9 +/- 2.1 (2-13). Type II lesions were present in 109 cases. There were 123 degenerative cases. Preoperative mitral regurgitation (MR) was severe in 145 cases. Ninety patients were in NYHA class III/IV. The transseptal approach was employed in 89.5% of the series. Annuloplasty alone was performed in 36 patients, whereas leaflet plication/exclusion was applied in 53 patients. The edge-to-edge technique was used in 79. Mitral valve repair was combined with procedures for ischaemic heart disease in 41 patients.


RESULTS
The mean postoperative stay was 8.1 +/- 3.7 days (4-25). There was no mortality in the isolated mitral valve repair group. New onset atrial fibrillation occurred in 17% postoperatively. Mean follow-up was 34.3 +/- 25.1 months (0-105). No or mild MR was present in 139 (91%) patients, while 144 (94%) were in NYHA class I. Four patients underwent redo repair. There was a statistically significant difference in relation to the MR between patients who had Alfieri repair with annuloplasty compared to no annuloplasty (p < 0.001). Furthermore, there was a significant difference between the isolated valve and the combined group in terms of postoperative hospital stay (p = 0.006) and survival (p = 0.033).


CONCLUSIONS
Our study demonstrates that the techniques beyond the "French correction" simplify the repair, especially when combined with other cardiac procedures. These techniques were applied with no mortality in the isolated mitral valve repair group.
Manchester Heart Centre, Manchester, UK. info@kotoulas.com
Christophoros
C
Kotoulas
Savvas
S
Omorphos
Ali
A
Sarraf
Kostas
K
Patris
Ragheb
R
Hasan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult