Journal of Chest Surgery

  • 제48권5호
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  • Pages.328-334
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  • 2015
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Postoperative Outcomes of Mitral Valve Repair for Mitral Restenosis after Percutaneous Balloon Mitral Valvotomy

  • Lee, Ji Seong (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Chee, Hyun Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Jun Seok (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Song, Myong Gun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Park, Jae Bum (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Shin, Je Kyoun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine)
  • 투고 : 2014.09.16
  • 심사 : 2014.11.07
  • 발행 : 2015.10.05
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초록

Background: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. Methods: In this study, we assessed 15 patients (mean age, $47.7{\pm}9.7years$; 11 female and 4 male) who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was $13.5{\pm}7years$. The mean preoperative Wilkins score was $9.4{\pm}2.6$. Results: The mean mitral valve area obtained using planimetry increased from $1.16{\pm}0.16cm^2$ to $1.62{\pm}0.34cm^2$ (p=0.0001). The mean pressure half time obtained using Doppler ultrasound decreased from $202.4{\pm}58.6ms$ to $152{\pm}50.2ms$ (p=0.0001). The mean pressure gradient obtained using Doppler ultrasound decreased from $9.4{\pm}4.0mmHg$ to $5.8{\pm}1.5mmHg$ (p=0.0021). There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period ($39{\pm}16months$). The 5-year event-free survival was 56.16% (95% confidence interval, 47.467-64.866). Conclusion: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.

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참고문헌

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