Original articleCardiovascularSurvival Advantage and Improved Durability of Mitral Repair for Leaflet Prolapse Subsets in the Current Era
Section snippets
Patients and Methods
This was a retrospective review of patients undergoing primary surgical correction of MV insufficiency (repair or replacement) for regurgitation due to leaflet prolapse. The study was reviewed and approved by the Mayo Clinic Institutional Review Board (IRB). As per IRB ruling, the need for individual patient consent was waived due to the fact that data were stripped of relevant identifiers. Those who requested not to participate in clinical research were excluded. Also excluded from the study
Baseline Characteristics
In Table 1, baseline characteristics of patients are stratified according to the patterns of leaflet prolapse. Those with isolated AL prolapse had poorer functional class, lower EF, larger left ventricular end systolic dimension (LVESD), and a greater prevalence of both significant CAD and preoperative MI. Patients with involvement of only the AL also had a decreased repair rate compared with those having either isolated PL or bileaflet (BL) prolapse.
Cumulative Mortality
Mortality data are presented in Table 2.
Comment
The present series follows 1,411 patients undergoing isolated surgical correction of MR due to leaflet prolapse over 20 years at a single institution. The cohort is free from several of the variables, such as the presence of ischemic and rheumatic MV pathologies and other nonmitral cardiac disease, which have confounded similar studies. The results demonstrate the clear survival advantage of MV repair over valve replacement, and the improving durability of valvuloplasty, which is now comparable
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