Mitral valve repair with patch augmentation for atrial functional mitral regurgitation complicated with giant left atrium
- Resource Type
- Original Paper
- Authors
- Sakon, Yoshito; Takahashi, Yosuke; Fujii, Hiromichi; Morisaki, Akimasa; Nishiya, Kenta; Yamane, Kokoro; Kishimoto, Noriaki; Kawase, Takumi; Murakami, Takashi; Shibata, Toshihiko
- Source
- General Thoracic and Cardiovascular Surgery. 71(2):104-112
- Subject
- Atrial fibrillation
Mitral regurgitation
Mitral valve repair
Patch augmentation
- Language
- English
- ISSN
- 1863-6705
1863-6713
Objective: We aimed to assess the results of posterior leaflet augmentation with an autologous pericardial patch in atrial functional mitral regurgitation.Methods: Data of 16 patients with atrial functional mitral regurgitation who underwent posterior leaflet patch augmentation for mitral valve repair were retrospectively analyzed. This procedure was applied to a short posterior leaflet with a height of < 10 mm in P2. The median age was 72.5 [67.8–78.3] years. Preoperative New York Heart Association functional class was II in 7 (43.8%) and III or IV in 9 (56.2%) patients. Mitral regurgitation was moderate in 2 (12.5%) and severe in 14 (87.5%) patients.Results: Operative mortality occurred in 1 (6.2%) patient due to cerebral infarction. One patient required valve replacement because of patch perforation early after operation. Mitral regurgitation was reduced to less than mild in 15 (93.8%) patients and less than trivial in 11 (68.8%) patients (P < 0.01) postoperatively. As for mid-term results, New York Heart Association functional class improved to I or II in 12 (75%) patients (P < 0.01). Two cases of thrombotic complication were observed. Remote recurrent regurgitation occurred in one case due to small patch size. The 3-year free rate of valve-related morbidity and regurgitation recurrence was 65.6% and 87.1%, respectively. The 5-year survival rate was 93.8%.Conclusions: Pericardial patch augmentation in atrial functional mitral regurgitation leads to good survival and mitral regurgitation recurrence-free rates. Steady anticoagulation and the use of larger patches would be necessary to reduce thrombotic complications and recurrent MR.