Rates of mitral valve repair compared to valve replacement vary widely by institution and by surgeon. The repair rate among patients in this study was 96.7 percent for all small-incision mitral valve procedures and 100 percent for patients with mitral valve regurgitation (leakage of blood through the valve). This is well above the current national average of 60 percent repair for all mitral valve operations and 70 percent with procedures to correct pure mitral valve regurgitation.
While there has been widespread adoption of minimally invasive, patient-friendly techniques is most areas of surgery, there has been little data to prompt the routine use of these techniques in mitral valve surgery, especially in cases where the valve can be repaired.
"The small-incision approach fits with our emphasis on mitral valve repair rather than replacement," says the study's senior author, Bartley P. Griffith, M.D., chief of Cardiac Surgery at the University of Maryland Medical Center and professor of surgery and head of the Division of Cardiac Surgery at the University of Maryland School of Medicine. "We prefer to fix a broken mitral valve rather than replace it, because a repair lasts longer and rarely requires another operation down the road."
The study was conducted between May 2003 and March 2009. The mean age of patients was 53.6 years and 64 percent of the patients were male. "The minimally invasive approach is not usually applicable for patients who are markedly obese, elderly or who have significantly reduced cardiac pumping function, or those who require aortic valve or coronary artery bypass grafting along with mitral valve surgery," says Dr. Gammie.
|Contact: Bill Seiler|
University of Maryland Medical Center