LATE RESULTS OF MITRAL VALVE REPAIR IN ADULTS WITH SEPTAL DEFECTS
Objective. To present the long-term results of mitral valve repair in adult patients with atrial or ventricular septal defects. Material and methods. The study included 25 patients aged from 16 to 61 years operated for septal defects and mitral insufficiency in 2000-2014. Seventeen (68%) patients had secondary atrial septal defects (in one of them there was a partial anomalous drainage of pulmonary veins), and in 8 (32%) cases there was ventricular septal defect. According to echocardiography, mitral insufficiency was assigned to Carpentier type 1 and had 2nd degree in 12 (48%) patients, 3rd degree in 12 (48%) patients, and 4th degree in 1 (4%) patient. Suture annuloplasty was performed in 10 (40%) patients, annuloplasty with the support ring (including the PTFE band) - in 8 (32%), multicomponent reconstitution - in 5 (20%), and Alfieri repair - in 2 (8%) patients. The concomitant procedures were tricuspid valve plastic in 9 cases and maze procedure in 3 cases. Results. Hospital mortality was zero. The mean follow-up period was 60 ± 11 months (5 years). Cardiac lethality is 0%, mitral insufficiency is regarded as minimal or 1st degree in 21 (84%) cases, 2nd degree - in 4 (16%) cases. All patients have I-II NYHA class. Conclusion. In all cases, the leading cause of mitral insufficiency was dilatation of the fibrous ring due to prolonged overload of the pulmonary circulation. Mitral valve repair in various modifications is an effective strategy with good long-term results.
About the authorsPodzolkov V.P.
Minaev Anton Vladimirovich
Подзолков В.П., Плотникова Л.Р., Амиркулов Б.Д. ВПС у больных старше 30 лет: структура, результаты хирургического лечения. Бюллетень НЦССХ им. А.Н. Бакулева. Сердечно-сосудистые заболевания. 2000; 1 (2): 14. [Podzolkov V.P., Plotnikova L.R., Amirkulov B.D. Congenital heart disease in adults: structure, results of surgical treatment. Byulleten 'Nauchnogo Tsentra Serdechno-Sosudistoy Khirurgii imeni A.N. Bakuleva. Serdechno-Sosudistye Zabolevaniya (The Bulletin of Bakoulev Center for Cardiovascular Surgery. Cardiovascular Diseases). 2000; 1 (2): 14 (in Russ.).]
Yoshida S., Numata S., Tsutsumi Y., Monta O., Yamazaki S., Seo H. et al. Mitral valve regurgitation after atrial septal defect repair in adults. J. Heart Valve Dis. 2014; 23 (3): 310-5.
Park J.J., Lee S.C., Kim J.B., Seo D.J., Song J.M., Yun S.C., Yun T.J. Deterioration of mitral valve competence after the repair of atrial septal defect in adults. Ann. Thorac. Surg. 2011; 92 (5): 1629-33. DOI: 10.1016/j.athoracsur.2011.05.118
Schreiber T.L., Feigenbaum H., Weyman A.E. Effect of atrial septal defect repair on left ventricular geometry and degree of mitral valve prolapse. Circulation. 1980; 61 (5): 888-96.
Webb G., Gatzoulis M.A. Atrial septal defects in the adult: recent progress and overview. Circulation. 2006; 114 (15): 1645-53. DOI: 10.1161/CIRCULATIONAHA.105.592055
Takaya Y., Kijima Y., Akagi T., Nakagawa K., Oe H., Taniguchi M. et al. Fate of mitral regurgitation after transcatheter closure of atrial septal defect in adults. Am. J. Cardiol. 2015; 116 (3): 458-62. DOI: 10.1016/j.amjcard.2015.04.042
Toyono M., Pettersson G.B., Matsumura Y., Wada N., Fukuda S., Yamano T. et al. Preoperative and postoperative mitral valve prolapse and regurgitation in adult patients with secundum atrial septal defects. Echocardiography. 2008; 25 (10): 1086-93. DOI: 10.1111/ j.1540-8175.2008.00726.x
Angel J., Soler-Soler J., Garcia del Castillo H., Anivarro I., Batlle-Diaz J. et al. The role of reduced left ventricular enddiastolic volume in the apparently high prevalence of mitral valve prolapsed in atrial septal defect. Eur. J. Cardiol. 1980; 11 (5): 341-55.
Joy J., Kartha C.C., Balakrishnan K.G. Structural basis for mitral valve dysfunction associated with ostium secundum atrial septal defects. Cardiology. 1993; 82 (6): 409-14.
Suchon E., Podolec P., Plazak W, Tomkiewicz-Pajak L., Pieculewicz M., Mura A., Tracz W. Mitral valve prolapse associated with ostium secundum atrial septal defect - a functional disorder. Acta Cardiol. 2004; 59 (2): 237-8.
Nagata S., Nimura Y., Sakakibara H., Beppu S., Park Y.D., Kawazoe K., Fujita T. Mitral valve lesion associated with secundum atrial septal defect. Analysis by real time two dimensional echocardiography. Br. Heart J. 1983; 49 (1): 51-8.
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