Results of modern mitral valve repair in patients with Marfan syndrome

TY - JOUR

T1 - Results of modern mitral valve repair in patients with Marfan syndrome

AU - Bernhardt, Alexander Martin

AU - Treede, Hendrik

AU - Detter, Christian

AU - Rybczynski, Meike

AU - Sheikhzadeh, Sara

AU - Wagner, Florian Mathias

AU - Von Kodolitsch, Yskert

AU - Reichenspurner, Hermann

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2014/2

Y1 - 2014/2

N2 - OBJECTIVES: Mitral valve (MV) regurgitation is a common manifestation in patients with Marfan syndrome (MFS) and is age dependent. Valve pathology shares some features with myxomatous MV disease. Surgical treatment is still being debated and not well characterized in patients with MFS.PATIENTS AND METHODS: We retrospectively evaluated the results of mitral valve repair (MVR) of symptomatic patients with MFS who underwent surgery between January 2004 and April 2011. MFS was diagnosed following the Ghent criteria. MVR was performed in 12 patients. Three patients underwent minimally invasive MVR despite severe thorax deformities. Mean follow-up was 60.1 months (95% CI: 48-72) and was complete.RESULTS: Thirty-day mortality was 0%. One patient died because of arrhythmia 66 months after MVR. Transthoracic echocardiography at last visit showed mild mitral regurgitation in one patient (8.3%) and no mitral regurgitation in the remaining patients (91.7%).CONCLUSION: MVR was associated with excellent survival and a low rate of complications. Transthoracic echocardiography showed good results of the repaired valves even years later. Minimally invasive repairs are feasible even in deformed thoraces, lowering the risk for future aortic surgery. Because of excellent mid-term to long-term results, MVR may also be justified in asymptomatic Marfan patients.

AB - OBJECTIVES: Mitral valve (MV) regurgitation is a common manifestation in patients with Marfan syndrome (MFS) and is age dependent. Valve pathology shares some features with myxomatous MV disease. Surgical treatment is still being debated and not well characterized in patients with MFS.PATIENTS AND METHODS: We retrospectively evaluated the results of mitral valve repair (MVR) of symptomatic patients with MFS who underwent surgery between January 2004 and April 2011. MFS was diagnosed following the Ghent criteria. MVR was performed in 12 patients. Three patients underwent minimally invasive MVR despite severe thorax deformities. Mean follow-up was 60.1 months (95% CI: 48-72) and was complete.RESULTS: Thirty-day mortality was 0%. One patient died because of arrhythmia 66 months after MVR. Transthoracic echocardiography at last visit showed mild mitral regurgitation in one patient (8.3%) and no mitral regurgitation in the remaining patients (91.7%).CONCLUSION: MVR was associated with excellent survival and a low rate of complications. Transthoracic echocardiography showed good results of the repaired valves even years later. Minimally invasive repairs are feasible even in deformed thoraces, lowering the risk for future aortic surgery. Because of excellent mid-term to long-term results, MVR may also be justified in asymptomatic Marfan patients.

KW - Adolescent

KW - Adult

KW - Aged

KW - Female

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Marfan Syndrome/complications

KW - Middle Aged

KW - Mitral Valve/physiopathology

KW - Mitral Valve Insufficiency/diagnosis

KW - Postoperative Complications/etiology

KW - Retrospective Studies

KW - Risk Factors

KW - Thoracotomy

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1055/s-0033-1348919

DO - 10.1055/s-0033-1348919

M3 - SCORING: Journal article

C2 - 23839872

VL - 62

SP - 35

EP - 41

JO - THORAC CARDIOV SURG

JF - THORAC CARDIOV SURG

SN - 0171-6425

IS - 1

ER -