title: Mid-term outcomes of mitral valve repair in a low-volume hospital.
abstract: BACKGROUND
  Mitral valve repair is feasible for all patients with mitral regurgitation and its advantages are well documented; however, there is general agreement that it is technically demanding and that success rates are related to volume/ experience centers. The aim of this study was to evaluate the clinical and echocardiographic mid-term outcomes of patients who underwent a mitral repair in a low-volume hospital.
  
  
  RESULTS
  Between 2009 and 2014, 55 patients (23 female) with mitral regurgitation underwent mitral repair. The mean age was 60.7±11.4 years (range, 21-81 yr). The most prevalent cardiovascular risk factors were: hypertension 61.8%, dyslipidemia 47.3% and diabetes 21.8%. Nine patients (16.4%) were in class III-IV of NYHA and ten (18.2%) had atrial fibrillation. Repair procedures included mitral ring annuloplasty (n=55), quadrangular resection (n=20), chordal replacement (n=13) and commissuroplasty (n=5). Postoperative complications included atrial fibrillation 16.4%, check bleeding 3.6%, wound infection 1.8% and renal failure 1.8%. The hospital mortality rate was 1.8%. Follow-up echocardiography (median 19±5 months) revealed trivial or no mitral regurgitation in 38.2%, mild (1+) in 34.5% and severe (3+) only in 3 patients.
  
  
  CONCLUSIONS
  In the current era, patients undergoing successful mitral valve repair have low mortality and morbidity even in low-volume hospitals.
authors.affiliation: Serviços de Cirurgia Cardiotorácica, de Cardiologia e de Anestesiologia do Centro Hospitalar de Vila Nova de Gaia / Espinho e Escola de Ciências da Saúde da Universidade do Minho, Braga, Portugal.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Gomes
authors.forename: Miguel
authors.initials: M
authors.lastname: Guerra
authors.forename: Daniel
authors.initials: D
authors.lastname: Martins
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Mota
authors.forename: Manuela
authors.initials: M
authors.lastname: Vieira
authors.forename: Eulália
authors.initials: E
authors.lastname: Pereira
authors.forename: José
authors.initials: J
authors.lastname: Ribeiro
authors.forename: Filipa
authors.initials: F
authors.lastname: Pinto-Ribeiro
authors.forename: Luís
authors.initials: L
authors.lastname: Vouga
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D061846:Hospitals, Low-Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome