Thorac Cardiovasc Surg 2006; 54(7): 464-467
DOI: 10.1055/s-2006-924438
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Decalcification of the Mitral Annulus: Surgical Experience in 81 Patients

M. Dietrich1 , M. Doss1 , T. Aybek1 , S. Martens1 , M. Scherer1 , G. Wimmer-Greinecker1 , A. Moritz1
  • 1JWG Universitätsklinik Frankfurt am Main, THG-Chirurgie, Frankfurt am Main, Germany
Further Information

Publication History

Received March 15, 2006

Publication Date:
06 November 2006 (online)

Abstract

Objective: Mitral valve surgery in the presence of extensive calcification of the mitral annulus is a technical challenge and increases perioperative risk. This study reviews our experience with decalcification of the mitral annulus in patients undergoing mitral valve reconstruction or replacement. Methods: From 1995 to 2003, 81 patients (mean age 64 ± 13 years, 30 male, 51 female) with extensive calcification of the mitral annulus underwent mitral valve repair (n = 42) or replacement (biological n = 20, mechanical n = 19). The mean follow-up was 24 months. Patients presented with a mean EuroSCORE of 7. Concomitant surgical procedures were performed in 62 %. Patient outcomes were retrospectively assessed. Results: Perioperative survival was 97.5 % (n = 79) and hospital survival was 91.3 % (n = 74). Two-year survival was 88.9 %. Eight patients needed reexploration due to bleeding and five patients required prolonged mechanical ventilation. No perioperative stroke was observed. Freedom from reoperation was 90.2 % (n = 73). Early reoperation for recurrent incompetence was necessary in 3 patients and late reoperation in 5 patients. Conclusions: Despite the elevated perioperative risk and the high risk of reoperation with this procedure, decalcification of the annulus and repair/replacement of the mitral valve could be performed with good clinical results.

References

  • 1 Savvage D D, Garrison R J, Castelli W P. et al . Prevalence of submitral (annular) calcium and its correlates in a general population-based sample (the Framingham Study).  Am J Cardiol. 1983;  51 1375-1378
  • 2 Roberts W, Perloff J. Mitral valvular disease: a clinicopathologic survey of the conditions causing the mitral valve to function abnormally.  Ann Intern Med. 1972;  77 939-975
  • 3 Carpentier A F, Pellerin M, Fuzellier J F, Relland J YM. Extensive calcification of the mitral valve anulus: pathology and surgical management.  J Thorac Cardiovasc Surg. 1996;  111 718-730
  • 4 Feindel C M, Tufail Z, David T E, Ivanov J, Armstrong S. Mitral valve surgery in patients with extensive calcification of the mitral annulus.  J Thorac Cardiovasc Surg. 2003;  126 777-781
  • 5 Nataf P, Pavie A, Jault F, Bors V, Cabrol C, Gandjbakhch I. Interatrial insertion of a mitral prosthesis in a destroyed or calcified mitral annulus.  Ann Thorac Surg. 1994;  58 163-167
  • 6 Vander Salm T J. Mitral valve surgery with extensive calcification of the annulus.  J Thorac Cardiovasc Surg. 2004;  127 609-610
  • 7 Grossi A G, Galloway A C, Steinberg B M. et al . Severe calcification does not affect long-term outcome of mitral valve repair.  Ann Thorac Surg. 1994;  58 685-688
  • 8 Deloche A, Jebara V A, Relland J YM. et al . Valve repair with Carpentier techniques: the second decade.  J Thorac Cardiovasc Surg. 1990;  99 990-1002

Markus Dietrich

JWG Universitätsklinik Frankfurt am Main
THG-Chirurgie

Theodor Stern Kai 7

60590 Frankfurt am Main

Germany

Phone: + 49 69 63 01 58 50

Fax: + 49 69 63 01 58 49

Email: md.md@gmx.de