Clinical and Echocardiographic Study of Mitral Valve Repair in A Tertiary Center in Oman

Introduction: In recent years, mitral valve (MV) repair has become the procedure of choice for treating isolated mitral regurgitation (MR). The aim of this study was to evaluate immediate and long-term clinical and echocardiographic results of MV repair performed at a tertiary hospital in Oman.Materials and Methods: The study population consisted of patients with severe MR above ۱۸years of age who had isolated MV repair between ۲۰۰۶ and ۲۰۱۶ at Royal Hospital, Oman. Retrospective observational study. Primary Endpoints: ۱-year freedom from reoperation, recurrence of severe MR and mortality. Secondary Endpoints: Five-year echocardiographic recurrence of severe MR, ejection fraction (EF), NYHA class and mortality.Results: The case records of ۳۵۱ patients with MR who had MV surgery in Royal Hospital were reviewed. A total of ۸۹ patients had isolated MV repair surgery with follow up ۱ year. The etiology of mitral disease was degenerative in ۵۸.۴۲%, rheumatic in ۲۰.۲۲%, post endocarditis in ۱۲.۳۵%, congenital ۵.۶۱% and ischemic MR in ۳.۳۷%. Operative mortality was ۲.۲۴% (۲/۸۹). Pre-operative NHYA class III/IV was noted in ۶۲.۹۲% of patients (۵۶/۸۹). All the patients had an EF of > ۶۰%.  Among the ۸۷ patients followed up for one-year, ۹۵.۴۰ % (۸۳/۸۷) of patients were free from reoperation. Four patients (۴.۵۹%) had recurrence of severe MR needing MV replacement surgery. Of the ۸۷ patients, ۵۶ patients were followed in our institute for ۵ years had demonstrated trivial to mild MR in ۷۳.۲% (۴۱/۵۶) moderate MR in ۱۶.۰۷% (۹/۵۶), and severe MR in ۱۰.۰۷% (۶/۵۶) of patients though ۸۳.۹۲% (۴۷/۵۶) patients were in NYHA class I. Majority of grade ۳ (۱۰.۷۱%) and ۴ MR (۸.۹۲%) occurred in patients with rheumatic etiology who underwent MV repair. Ejection fraction remained > ۶۰% in ۸۹.۲۸% patients. There was no mortality at ۵ years among the ۵۶ patients followed-up.Conclusions: MV repair in a tertiary center in Oman showed favorable early and one-year results as regards mortality, freedom from reoperation and recurrence of significant MR. Those followed-up at five years, majority of patients were asymptomatic though echocardiographic recurrence of moderate and severe MR was high predominantly in patients with rheumatic etiology.

کلیدواژه ها:

Mitral valve repair ، mitral regurgitation ، NYHA class ، Reoperation