Non-ischaemic mitral valve suture annuloplasty: late follow-up results.
OBJECTIVE
To evaluate late outcomes after posterior mitral valve (MV) annulus double-suture annuloplasty for degenerative (non-ischaemic) MV insufficiency.


METHODS
Between 2005 and 2011, 138 patients underwent MV repair using posterior MV double-suture annuloplasty and an additional 105 patients underwent tricuspid valve repair. The study protocol included operative mortality, reoperation rate and reasons, as well as echocardiographic parameters at pre- and postoperative and follow-up periods (2-9 years).


RESULTS
In-hospital mortality was 2/138 (1.45%). Early post operation, no regurgitation was noted in 74/136 (54.4%) patients, I(o) regurgitation was observed in 55/136 (40.4%), II(o) was observed in 6/136 (4.4%) and III(o) was observed in 1/136 (0.7%); during late follow-up (from 2 to 9 years), no regurgitation was observed in 21.6% patients, I(o) was observed in 58%, II(o) was observed in 17% and III(o) was observed in 3.4%. The mean preoperative anterolateral diameter of the MV annulus was 39.02±4.97 mm and, at late follow-up, it was 27.66±3.94 mm (p=0.000); at these same time points, left ventricular end-diastolic diameter (LVEDD) was 55.74±7.29 mm and 49.17±6.01 mm (p=0.000), respectively, and the left ventricular ejection fraction (LVEF) was 53.08±8.93% and 50.92±6.78%, respectively (p=0.007).


CONCLUSIONS
This study demonstrates suture annuloplasty to be an effective treatment up to 9 years for degenerative mitral valve disease. This technique enables preservation of the posterior mitral valve annulus diameter with stable long-term (up to 9 years) reduction, a competent (no regurgitation/⩽II(o) regurgitation) MV in 96.6% of cases and positive left ventricular (LV) remodelling.
Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania Cardiac Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Rimantas
R
Benetis
Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Paulius
P
Orda
Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania jvaskelyte@gmail.com.
Jolanta Justina
JJ
Vaškelytė
Cardiac Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Vytenis
V
Ivanauskas
Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Eglė
E
Ereminienė
Cardiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania Cardiac Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Povilas
P
Jakuška
Cardiac Surgery Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Loreta
L
Jankauskienė
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
echocardiography; mitral regurgitation; mitral valve annulus; non-ischaemic mitral valve; suture annuloplasty