Mitral Valve Repair Is Still A Reasonable Option In The Absence Of An Intraoperative Echocardiography

Volume : VII, Issue : V, May - 2018

Dr Ratish Radhakrishnan, Dr. Joseph Thomas Kathayanatt, Dr Aravind S Ganapath

Mitral valve repair is the treatment of choice in patients with mitral insufficiency. Mechanical valves, even when functioning perfectly, are less

efficient hemodynamically than a native mitral valve and also have attendant morbidity from thrombolism, anticoagulant–related hemorrhage, and

endocarditis. Long–term data have confirmed the durability of mitral repair. Mitral valve repair was performed on 64 consecutive patients between

Nov. 2009 and april 2013,. The repair technique included quadrangular resection, artificial chordae placement, chordal transfer, and chordal

shortening. In all patients repair was reinforced with flexible incomplete annuloplasty ring. There were 64 patients(consecutive) in our study.Of

these 37 were males(57.8%).Most of our patients were having mitral valve prolapse(50%).Other etiologies being Rheumatic (26.5%). Associated

procedures included AVR(4/64), Tricuspid repair(4/64), LV aneurysm repair(1) and ASD closure(1).All patients underwent placement of

annuloplasty with flexible incomplete ring. Additional procedures included triangular resection, quadrangular resection, placement of synthetic

chordae , commisurotomy, chordal splitting and closure of clefts. The approach valve was mostly through LA. All cases had moderate or mod–sev

or severe MR. Before and after repair they underwent saline test. Our hospital did not have the privilege of an intraop TEE during the period of

study. No patients had more than mild MR post op.