Echocardiographic and clinical outcome after mitral valve plasty with a minimal access or conventional sternotomy approach

The Journal of Cardiovascular Surgery
Lotte E de Groot-de LaatMarcel L Geleijnse

Abstract

To evaluate the effects of minimal access mitral valve surgery (MAMVS) versus conventional surgery with or without concomitant tricuspid valve plasty (TVP) in consecutive patients with mitral regurgitation (MR) on clinical and echocardiographic outcome. One-hundred-and-twenty patients operated for MR (91 conventional and 29 MAMVS) were followed by echocardiography and quality-of-life assessment before and 6 months after surgery. Patients in the MAMVS group were younger, more often in NYHA functional class I-II and had lower NT-proBNP levels. Only four patients (all in the conventional group) underwent mitral valve replacement. There were no significant differences in complications between MAMVS and conventional surgery. At 6-months comparable MR reduction and left ventricular remodeling data were seen, left atrial remodeling was most prominent in the MAMVS group, 71[55-90] to 43[35-58] versus 69[53-89] to 49[41-70] ml/m2 in the conventional group (P <0.05). Significant improvement for all quality of life domains were seen, except for pain, with no intergroup differences. Twenty-seven (23%) patients underwent concomitant TVP, all in the conventional group. Tricuspid regurgitation decreased after concomitant TVP (P < 0.001), wher...Continue Reading

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