Skip to main content
SpringerLink
Log in

Mitral valve repair for degenerative mitral valve regurgitation

  • Review Article
  • Published:
Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

In industrialized countries, the most common etiology of mitral regurgitation (MR) is degenerative mitral valve (MV) disease. The natural history of severe degenerative MR is poor. However, its appropriate and timely correction is associated with a life expectancy similar to that of the normal population. Surgical MV repair is the gold-standard treatment. This review will focus on the most recent evidence with a specific emphasis on surgical indications, timing of treatment, contemporary surgical techniques, Heart Teams, and Centers of Excellence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Carpentier A. Cardiac valve surgery--the French correction. J Thorac Cardiovasc Surg. 1983;86:323–37.

    Article  CAS  Google Scholar 

  2. Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352:875–83.

    Article  CAS  Google Scholar 

  3. David TE, Armstrong S, Sun Z, Daniel L. Late results of mitral valve repair for mitral regurgitation due to degenerative disease. Ann Thorac Surg. 1993;56:7–12.

    Article  CAS  Google Scholar 

  4. Gillinov AM, Cosgrove DM, Blackstone EH, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg. 1998;116:734–43.

    Article  CAS  Google Scholar 

  5. Mohty D, Orszulak TA, Schaff HV, Avierinos JF, Tajik JA, Enriquez-Sarano M. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation. 2001;104:I1–7.

    Article  CAS  Google Scholar 

  6. Deloche A, Jebara VA, Relland JY, et al. Valve repair with Carpentier techniques. The second decade. J Thorac Cardiovasc Surg. 1990;99:990–1001.

    CAS  PubMed  Google Scholar 

  7. David TE, Ivanov J, Armstrong S, Christie D, Rakowski H. A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapse. J Thorac Cardiovasc Surg. 2005;130:1242–9.

    Article  Google Scholar 

  8. Perier P. A new paradigm for the repair of posterior leaflet prolapse: respect rather than resect. Op Tech Thorac Cardiovasc Surg. 2005;10:180–93.

    Article  Google Scholar 

  9. Carpentier A, Relland J, Deloche A, et al. Conservative management of the prolapsed mitral valve. Ann Thorac Surg. 1978;26:294–302.

    Article  CAS  Google Scholar 

  10. Perier P, Stumpf J, Götz C, et al. Valve repair for mitral regurgitation caused by isolated prolapse of the posterior leaflet. Ann Thorac Surg. 1997;64:445–50.

    Article  CAS  Google Scholar 

  11. Braunberger E, Deloche A, Berrebi A, et al. Very long-term results (more than 20 years) of valve repair with carpentier's techniques in nonrheumatic mitral valve insufficiency. Circulation. 2001;104:I8–11.

    Article  CAS  Google Scholar 

  12. Mihaileanu S, Marino JP, Chauvaud S, et al. Left ventricular outflow obstruction after mitral valve repair (Carpentier's technique). Proposed mechanisms of disease. Circulation. 1988;78:I78–84.

    CAS  PubMed  Google Scholar 

  13. Carpentier A. The sliding leaflet technique. Le Club Mitrale Newsletter. 1988:1–5.

  14. Jebara VA, Mihaileanu S, Acar C, et al. Left ventricular outflow tract obstruction after mitral valve repair. Results of the sliding leaflet technique. Circulation. 1993;88:II30–4.

    CAS  Google Scholar 

  15. Perier P, Clausnizer B, Mistarz K. Carpentier "sliding leaflet" technique for repair of the mitral valve: early results. Ann Thorac Surg. 1994;57:383–6.

    Article  CAS  Google Scholar 

  16. Suri RM, Orszulak TA. Triangular resection for repair of mitral regurgitation due to degenerative disease. Op Tech Thorac Cardiovasc Surg. 2005;10:194–9.

    Article  Google Scholar 

  17. Perier P, Hohenberger W, Lakew F, et al. Toward a new paradigm for the reconstruction of posterior leaflet prolapse: midterm results of the "respect rather than resect" approach. Ann Thorac Surg. 2008;86:718–25.

    Article  Google Scholar 

  18. Falk V, Seeburger J, Czesla M, et al. How does the use of polytetrafluoroethylene neochordae for posterior mitral valve prolapse (loop technique) compare with leaflet resection? A prospective randomized trial. J Thorac Cardiovasc Surg. 2008;136:1205.

    Article  Google Scholar 

  19. Padala M, Powell SN, Croft LR, Thourani VH, Yoganathan AP, Adams DH. Mitral valve hemodynamics after repair of acute posterior leaflet prolapse: quadrangular resection versus triangular resection versus neochordoplasty. J Thorac Cardiovasc Surg. 2009;138:309–15.

    Article  Google Scholar 

  20. Iung B, Baron G, Butchart EG, et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003;24:1231–43.

    Article  Google Scholar 

  21. Dreyfus GD, Bahrami T, Alayle N, Mihealainu S, Dubois C, De Lentdecker P. Repair of anterior leaflet prolapse by papillary muscle repositioning: a new surgical option. Ann Thorac Surg. 2001;71:1464–70.

    Article  CAS  Google Scholar 

  22. Vetter HO, Burack JH, Factor SM, Frater RWM. Replacement of chordae tendineae of the mitral valve using the new expanded PTFE suture in sheep. In: Bodnar E, Yacoub M, editors. Biologic and bioprosthetic valves. New York: Yorke Medical Books; 1986. p. 772–84.

    Google Scholar 

  23. David TE. Replacement of chordae tendineae with expanded polytetrafluoroethylene sutures. J Card Surg. 1989;4:286–90.

    Article  CAS  Google Scholar 

  24. David TE. Artificial chordae. Semin Thorac Cardiovasc Surg. 2004;16:161–8.

    Article  Google Scholar 

  25. Salvador L, Mirone S, Bianchini R, et al. A 20-year experience with mitral valve repair with artificial chordae in 608 patients. J Thorac Cardiovasc Surg. 2008;135:1280–7.

    Article  Google Scholar 

  26. di Gioia CR, Brancaccio G, Sinatra R, Gallo P. Long-term histologic features of synthetic chordal replacement for mitral valve repair: a case report. Cardiovasc Pathol. 2001;10:87–9.

    Article  Google Scholar 

  27. Carpentier A, Loulmet D, Carpentier A, et al. [Open heart operation under videosurgery and minithoracotomy. First case (mitral valvuloplasty) operated with success]. C R Acad Sci III. 1996;319:219–23.

    CAS  PubMed  Google Scholar 

  28. Modi P, Rodriguez E, Hargrove WC 3rd, Hassan A, Szeto WY, Chitwood WR Jr. Minimally invasive video-assisted mitral valve surgery: a 12-year, 2-center experience in 1178 patients. J Thorac Cardiovasc Surg. 2009;137:1481–7.

    Article  Google Scholar 

  29. Seeburger J, Borger MA, Doll N, et al. Comparison of outcomes of minimally invasive mitral valve surgery for posterior, anterior and bileaflet prolapse. Eur J Cardiothorac Surg. 2009;36:532–8.

    Article  Google Scholar 

  30. Suri RM, Schaff HV, Meyer SR, Hargrove WC 3rd. Thoracoscopic versus open mitral valve repair: a propensity score analysis of early outcomes. Ann Thorac Surg. 2009;88:1185–90.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Herzchirurgie, Rhön Klinikum Campus Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt/Saale, Germany

    Patrick Perier, Wolfgang Hohenberger, Gerhard Batz, Fitsum Lakew & Anno Diegeler

Authors
  1. Patrick Perier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wolfgang Hohenberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerhard Batz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fitsum Lakew
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anno Diegeler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrick Perier.

Ethics declarations

Ethical statement, informed consent, human and animal rights statement not applicable being a review article.

Conflict of interest

NA

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perier, P., Hohenberger, W., Batz, G. et al. Mitral valve repair for degenerative mitral valve regurgitation. Indian J Thorac Cardiovasc Surg 36 (Suppl 1), 12–17 (2020). https://doi.org/10.1007/s12055-019-00823-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12055-019-00823-0

Keywords

Search

Navigation