PMID- 15223406 OWN - NLM STAT- MEDLINE DCOM- 20050505 LR - 20051116 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 78 IP - 1 DP - 2004 Jul TI - Edge-to-edge mitral valve repair: the Columbia Presbyterian experience. PG - 73-6 AB - BACKGROUND: The edge-to-edge mitral valve repair, first described by Alfieri in 1995 treats mitral regurgitation when standard reparative techniques are difficult, unlikely to succeed, or have failed. This study examines one institution's medium-term experience with this procedure. METHODS: This study involved patients undergoing edge-to-edge mitral valve repair at a single institution from 1997 to 2003. Preoperative and postoperative echocardiograms were compared. Postoperative morbidity was examined including need for reoperation and long-term medical management. Thirty-day survival and long-term actuarial survival were also determined. RESULTS: Seventy-one patients comprised this study. Mitral regurgitation on echocardiogram went from 3.43 +/- 0.86 to 0.39 +/- 0.61 (p < 0.001) following repair. Thirty-day mortality was 3 of 71 (4.2%) patients. Actuarial survivals at 24 and 60 months were 84.5% and 58.3%, respectively; adjusted excluding noncardiac death they were 89.5% and 82.3%, respectively. Forty (56.3%) patients had concomitant ring placement and experienced similar survival to those repaired with the bow-tie stitch alone. Home telephone follow-up was conducted, and current medical therapy was determined on 51 patients; 59% were on a beta-blocker, 31% were on an angiotensin-converting enzyme (ACE) inhibitor, 27% were on a diuretic, and 22% were on digoxin. All were New York Heart Association (NYHA) class I or II. Three patients (4.2%) underwent mitral valve reoperation after a mean of 299 +/- 429 days. In no case did the bow-tie suture rupture. CONCLUSIONS: Edge-to-edge mitral valve repair is a valuable tool in the armamentarium available to treat complex cases of mitral insufficiency or as an adjunct to standard repair techniques that fail to achieve an acceptable result. FAU - Kherani, Aftab R AU - Kherani AR AD - Department of Cardiothoracic Surgery, Columbia-Presbyterian Medical Center, New York, New York 10032, USA. khera001@mc.duke.edu FAU - Cheema, Faisal H AU - Cheema FH FAU - Casher, Jennifer AU - Casher J FAU - Fal, Jennifer M AU - Fal JM FAU - Mutrie, Christopher J AU - Mutrie CJ FAU - Chen, Jonathan M AU - Chen JM FAU - Morgan, Jeffrey A AU - Morgan JA FAU - Vigilance, Deon W AU - Vigilance DW FAU - Garrido, Mauricio J AU - Garrido MJ FAU - Smith, Craig R AU - Smith CR FAU - Oz, Mehmet C AU - Oz MC LA - eng PT - Journal Article PT - Review PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - 0 (Cardiovascular Agents) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Cardiac Surgical Procedures/*methods/statistics & numerical data MH - Cardiovascular Agents/therapeutic use MH - Coronary Artery Bypass/statistics & numerical data MH - Female MH - Follow-Up Studies MH - Heart Atria/surgery MH - Heart Septal Defects, Atrial/surgery MH - Heart Septal Defects, Ventricular/surgery MH - Humans MH - Life Tables MH - Male MH - Middle Aged MH - Mitral Valve/*surgery MH - Mitral Valve Insufficiency/drug therapy/epidemiology/etiology/mortality/*surgery MH - New York City MH - Postoperative Complications/surgery MH - Reoperation/statistics & numerical data MH - Retrospective Studies MH - Survival Analysis MH - Treatment Outcome RF - 18 EDAT- 2004/06/30 05:00 MHDA- 2005/05/06 09:00 CRDT- 2004/06/30 05:00 PHST- 2003/08/28 00:00 [accepted] PHST- 2004/06/30 05:00 [pubmed] PHST- 2005/05/06 09:00 [medline] PHST- 2004/06/30 05:00 [entrez] AID - S0003497503022483 [pii] AID - 10.1016/j.athoracsur.2003.08.085 [doi] PST - ppublish SO - Ann Thorac Surg. 2004 Jul;78(1):73-6. doi: 10.1016/j.athoracsur.2003.08.085.