Original articleAdult cardiacA “Repair-All” Strategy for Degenerative Mitral Valve Disease Safely Minimizes Unnecessary Replacement
Section snippets
Patients and Methods
The data used in this study were in part retrieved from the University of Pennsylvania’s prospective Society of Thoracic Surgeon’s registry and from each patient’s medical record. These data were approved for use in research by the University of Pennsylvania Institutional Review Board.
Results
Baseline demographics and risk profiles are summarized in Table 1. Patients with anterior or bileaflet prolapse were generally younger at the time of their operation and were more likely to be female with a smaller body mass index. Hypertension and a lower preoperative ejection fraction were significantly more prevalent in patients with anterior or bileaflet prolapse. Compared with patients who underwent mitral operations via a median sternotomy, patients selected for minithoracotomy tended to
Comment
In general, patients with degenerative MR benefit in event-free and overall survival if the MV is repaired instead of replaced. The increased morbidity and mortality associated with MV replacement is typically from higher reoperation rates due to prosthesis failure or complications of obligatory anticoagulation. Regrettably, the replacement of myxomatous MVs is not uncommon, including in developed nations 18, 19.
In an analysis of 13,614 patients in The Society of Thoracic Surgeons Adult Cardiac
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