Simple Interrupted Suturing for Redo Mitral Valve Replacement. 2016

Hiroshi Furukawa, and Taishi Tamura, and Takeshi Honda, and Hiroki Takiuchi, and Masahiko Kuinose, and Kazuo Tanemoto
Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan. Electronic correspondence: hfurukawa@med.kawasaki-m.ac.jp.

An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR). Among 336 mitral valve surgery patients at the authors' institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three. The number of previous surgeries was one in 10 patients, two in seven, and three in four. With regards to surgical technique, sharp dissection was initially performed on one side of the previous prosthetic sewing cuff, and the overall sewing cuff was thereafter completely removed following leaflet detachment. SIS (mean number of sutures 32.5 ± 3.0; range: 28-40 sutures) was performed to implant the new prosthesis, without exposing the rough surface of the previous mitral valve annulus, thereby allowing for eventual implantation of the same-sized or larger-sized prosthesis. The surgical procedure was successfully performed in all patients without any serious complications. Bioprostheses were selected for 11 patients, and mechanical valves for 10. Sixteen patients (76.2%) received a new prosthesis that was the same size as or larger than the previous prosthesis. Operative mortality within 30 days was 4.8%, which was similar to that of primary MVR in the same period (n = 83; 2.4%; p = 0.57). Recurrent PVL was detected in only one patient, who underwent a fourth surgery for SVD of the bioprosthesis. SIS for redo MVR may allow for the implantation of larger prostheses, and this novel maneuver may achieve acceptable early clinical outcomes.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008943 Mitral Valve The valve between the left atrium and left ventricle of the heart. Bicuspid Valve,Bicuspid Valves,Mitral Valves,Valve, Bicuspid,Valve, Mitral,Valves, Bicuspid,Valves, Mitral
D008944 Mitral Valve Insufficiency Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation. Mitral Incompetence,Mitral Regurgitation,Mitral Valve Incompetence,Mitral Insufficiency,Mitral Valve Regurgitation,Incompetence, Mitral,Incompetence, Mitral Valve,Insufficiency, Mitral,Insufficiency, Mitral Valve,Regurgitation, Mitral,Regurgitation, Mitral Valve,Valve Incompetence, Mitral,Valve Insufficiency, Mitral,Valve Regurgitation, Mitral
D011475 Prosthesis Failure Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking. Prosthesis Loosening,Prosthesis Durability,Prosthesis Migration,Prosthesis Survival,Durabilities, Prosthesis,Durability, Prosthesis,Failure, Prosthesis,Failures, Prosthesis,Loosening, Prosthesis,Loosenings, Prosthesis,Migration, Prosthesis,Migrations, Prosthesis,Prosthesis Durabilities,Prosthesis Failures,Prosthesis Loosenings,Prosthesis Migrations,Prosthesis Survivals,Survival, Prosthesis,Survivals, Prosthesis
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D004696 Endocarditis Inflammation of the inner lining of the heart (ENDOCARDIUM), the continuous membrane lining the four chambers and HEART VALVES. It is often caused by microorganisms including bacteria, viruses, fungi, and rickettsiae. Left untreated, endocarditis can damage heart valves and become life-threatening. Infective Endocarditis,Endocarditides,Endocarditides, Infective,Endocarditis, Infective,Infective Endocarditides
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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