Mitral valve repair offers superior long-term survival, freedom from cardiac morbidity,
and quality of life in patients with severe mitral regurgitation compared to medical
management and mitral valve replacement; it is the treatment of choice in these patients.
Mitral valve repair is the only treatment that restores normal life expectancy to
otherwise healthy patients with advanced degenerative mitral valve disease. This review
focuses on indications, timing and techniques for mitral valve repair in degenerative
disease, emphasising the importance of anatomy in surgical outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Quantitative determinants of the outcome of asymptomatic mitral regurgitation.N Engl J Med. 2005; 352: 875-883
- Is repair preferable to replacement for ischemic mitral regurgitation?.J Thorac Cardiovasc Surg. 2001; 122: 1125-1141
- Ischemic mitral valve reconstruction and replacement: comparison of long-term survival and complications.J Thorac Cardiovasc Surg. 2001; 122: 1107-1124
- ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons.Circulation. 2006; 114: e84-e231
- Large annuloplasty rings facilitate mitral valve repair in Barlow's disease.Ann Thorac Surg. 2006; 82 ([discussion 101]): 2096-2100
- Surgical treatment of asymptomatic and mildly symptomatic mitral regurgitation.J Thorac Cardiovasc Surg. 1996; 112 ([discussion 8-9]): 1240-1248
- Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients.Eur J Cardiothorac Surg. 2008;
Executive Summary STS Spring 2006 Report: The Society of Thoracic Surgery; 2006.
Keogh B, KR. The Society of Cardiothoracic Surgeons of Great Britain and Ireland Fifth National Adult Cardiac Surgical Database Report 2003. Henley-on-Thames: Dendrite Clinical Systems; 2004.
- A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease.Eur Heart J. 2003; 24: 1231-1243
- Pitfalls and limitations in measuring and interpreting the outcomes of mitral valve repair.J Thorac Cardiovasc Surg. 2006; 131: 523-529
- Current concepts in mitral valve repair for degenerative disease.Heart Fail Rev. 2006; 11: 241-257
- Cardiac valve surgery—the “French correction”.J Thorac Cardiovasc Surg. 1983; 86: 323-337
- Reconstructive surgery of mitral valve incompetence: ten-year appraisal.J Thorac Cardiovasc Surg. 1980; 79: 338-348
- The “physio-ring”: an advanced concept in mitral valve annuloplasty.Ann Thorac Surg. 1995; 60 ([discussion 85-6]): 1177-1185
- Etiologic classification of degenerative mitral valve disease: Barlow's disease and fibroelastic deficiency.Semin Thorac Cardiovasc Surg. 2007; 19: 90-96
- Does this patient have an abnormal systolic murmur?.JAMA. 1997; 277: 564-571
- Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation?.Circulation. 2001; 104: I68-I75
- How leaky is that mitral valve? Simplified Doppler methods to measure regurgitant orifice area.Circulation. 1997; 95: 548-550
- Treatment of chronic mitral regurgitation.Am Heart J. 1998; 135: 925-936
- Timing of mitral valve surgery.Heart. 2002; 87: 79-85
- ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography—summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography).J Am Coll Cardiol. 2003; 42: 954-970
- Geometric differences of the mitral valve tenting between anterior and inferior myocardial infarction with significant ischemic mitral regurgitation: quantitation by novel software system with transthoracic real-time three-dimensional echocardiography.J Am Soc Echocardiogr. 2006; 19: 71-75
- Natural history of severe mitral regurgitation.Eur Heart J. 1991; : 5-9
- Effect of prosthetic heart valve replacement on the natural course of isolated mitral and aortic as well as multivalvular diseases. Clinical results in 783 patients up to 8 years following implantation of the Bjork-Shiley tilting disc prosthesis.Z Kardiol. 1983; 72: 494-503
- Clinical outcome of mitral regurgitation due to flail leaflet.N Engl J Med. 1996; 335: 1417-1423
- Sudden death in mitral regurgitation due to flail leaflet.J Am Coll Cardiol. 1999; 34: 2078-2085
- ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons.J Am Coll Cardiol. 2006; 48: e1-e148
- Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications.Circulation. 1999; 99: 400-405
- Determinants of survival and left ventricular performance after mitral valve replacement. Department of Veterans Affairs Cooperative Study on Valvular Heart Disease.Circulation. 1990; 81: 1173-1181
- Outcome after surgery for mitral regurgitation. Determinants of postoperative morbidity and mortality.J Heart Valve Dis. 1997; 6: 17-21
- Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation.Circulation. 1994; 90: 830-837
- Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications.J Am Coll Cardiol. 1994; 24: 1536-1543
- Echocardiographic analysis of left atrial size before and after operation in mitral valve disease.Am J Cardiol. 1979; 43: 171-178
- Cox–maze procedure for atrial fibrillation: Mayo Clinic experience.Semin Thorac Cardiovasc Surg. 2000; 12: 30-37
- The efficacy of the Cox/maze procedure combined with mitral valve surgery: a matched control study.Eur J Cardiothorac Surg. 2001; 19: 438-442
- Intraoperative options for treating atrial fibrillation associated with mitral valve disease.J Thorac Cardiovasc Surg. 2001; 122: 212-215
- European system for cardiac operative risk evaluation (EuroSCORE).Eur J Cardiothorac Surg. 1999; 16: 9-13
- Determinants of pulmonary hypertension in left ventricular dysfunction.J Am Coll Cardiol. 1997; 29: 153-159
- Outcome of watchful waiting in asymptomatic severe mitral regurgitation.Circulation. 2006; 113: 2238-2244
- Transposition of chordae in mitral valve repair. Mid-term results.Circulation. 1993; 88: II35-II38
Carpentier A, Adams DH, Filsoufi, F. Carpentier's Valve Reconstruction. Philadelphia: W.B.Saunders; In Press.
- Mitral valve repair by replacement of chordae tendineae with polytetrafluoroethylene sutures.J Thorac Cardiovasc Surg. 1991; 101: 495-501
- Early and mid-term results of mitral valve repair using premeasured Gore-Tex loops (‘loop technique’).Eur J Cardiothorac Surg. 2008; 33: 566-572
- Mitral valve repair in patients with endomyocardial fibrosis.Ann Thorac Surg. 1992; 54: 89-92
- Conservative operation for mitral insufficiency: critical analysis supported by postoperative hemodynamic studies of 72 patients.J Thorac Cardiovasc Surg. 1980; 79: 326-337
- Mitral valve annuloplasty: the effect of the type on left ventricular function.Ann Thorac Surg. 1989; 47 ([discussion 527-8]): 524-527
- The intraoperative “ink test”: a novel assessment tool in mitral valve repair.J Thorac Cardiovasc Surg. 2007; 133: 1635-1636
- Repair versus replacement for degenerative mitral valve disease with coexisting ischemic heart disease.J Thorac Cardiovasc Surg. 2003; 125: 1350-1362
- Influence of hospital procedural volume on care process and mortality for patients undergoing elective surgery for mitral regurgitation.Circulation. 2007; 115: 881-887
- Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis.Circulation. 1995; 91: 1022-1028
- Ischemic mitral regurgitation redux—to repair or to replace?.J Thorac Cardiovasc Surg. 2001; 122: 1059-1062
- Use of mitral valve repair: analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database.Ann Thorac Surg. 2003; 75: 820-825
- Quality of life after mitral valve repair.J Heart Valve Dis. 2005; 14: 722-726
- Recurrence of mitral valve regurgitation after mitral valve repair in degenerative valve disease.Circulation. 2003; 107: 1609-1613
- Durability of mitral valve repair in Barlow disease versus fibroelastic deficiency.J Thorac Cardiovasc Surg. 2008; 135: 274-282
- Seeking a higher standard for degenerative mitral valve repair: begin with etiology.J Thorac Cardiovasc Surg. 2008; 136: 551-556
- The cardiologist's role in increasing the rate of mitral valve repair in degenerative disease.Curr Opin Cardiol. 2008; 23: 105-110
- Mitral repair best practice: proposed standards.Heart. 2006; 92: 939-944
Article info
Publication history
Accepted:
February 7,
2009
Received:
December 11,
2008
Identification
Copyright
© 2009 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.