title: Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients.
abstract: OBJECTIVE
  Mitral valve repair has become the procedure of choice for almost every type of mitral regurgitation (MR) in the current surgical era. We assessed clinical outcomes of mitral valve repair in severe MR.
  
  
  METHODS
  In this prospective cohort study, 103 patients (61 male, 42 female, mean age 53.2±14.8 years), who were planned to undergo valve repair were included. Mitral valve pathology was regurgitant in 86% and mixed in 14% of patients. The intention to perform mitral repair was successful in 100 (97.1%) of patients. Concomitant procedures were performed in 57 (57%) patients including 31 coronary artery bypass grafting and 13 tricuspid valve repairs. After surgery, early (<30 days) and late (>30 days) complications were recorded. Postoperative echocardiography was performed in all patients at discharge and during clinical follow-up. Late survival and freedom from adverse events including thromboembolism, endocarditis, reoperation, and residual severe MR were estimated by using the Kaplan-Meier survival analysis.
  
  
  RESULTS
  There was no early mortality. Echocardiographic assessment of patients at discharge revealed no/trivial regurgitation in 89% and mild (1+) MR in 11% of all patients. Late mortality occurred in only one patient at 14 months because of renal failure. The mean follow-up period of patients was 21.2±10.3 months. Echocardiographic examination during follow-up revealed that mitral insufficiency was none or mild in 96% of patients. Three (3%) patients had moderate (2+) MR and were treated medically. Mitral insufficiency recurrence with severe (3+) regurgitation occurred in one (1%) patient undergoing coronary artery revascularization and concomitant left ventricular aneurysmectomy. Re-operation was needed in only one (1%) case because of infective endocarditis that was treated with mechanical valve replacement. Kaplan-Meier estimates were 99±2.7% for late survival and 98±2.2%, 99±2.7%, 99±2.7% and 99±0.9% for freedom from thromboembolism, endocarditis, reoperation, and residual severe MR, respectively.
  
  
  CONCLUSIONS
  This study showed that mitral valve repair provides excellent surgical outcomes. Repair procedures are safe, and highly effective, but operations require a considerable surgical experience.
authors.affiliation: Clinic of Cardiovascular Surgery, Sema Hospital, İstanbul, Turkey. aakorkmaz@gmail.com
authors.forename: Aşkın Ali
authors.initials: AA
authors.lastname: Korkmaz
authors.forename: Burak
authors.initials: B
authors.lastname: Onan
authors.forename: Ali Soner
authors.initials: AS
authors.lastname: Demir
authors.forename: Sevim Indelen
authors.initials: SI
authors.lastname: Tarakçı
authors.forename: Recep
authors.initials: R
authors.lastname: Gündoğdu
authors.forename: Ilyas
authors.initials: I
authors.lastname: Akdemir
authors.forename: Mustafa
authors.initials: M
authors.lastname: Güden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult