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Original Articles: Adult Cardiac

Midterm Survival After Decalcification of the Mitral Annulus

Department of Thoracic and Cardiovascular Surgery, Johann-Wolfgang-Goethe University, Frankfurt/Main, Germany

Accepted for publication December 12, 2008.

^_* Address correspondence to Dr Papadopoulos, Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, Frankfurt am Main, 60590, Germany (Email: nestoras.papadopoulos{at}gmail.com).

Background: The aim of this study is to determine the midterm outcomes of patients who underwent decalcification and patch-reconstruction of the mitral annulus during mitral valve surgery in our department.

Methods: Between 1996 and 2004, a total of 81 consecutive patients with a mean age of 64 ± 13 years underwent mitral valve surgery in the presence of extensive calcification of mitral annulus. In the majority of cases (n = 42, 52%), a mitral valve repair was performed after decalcification and patch-reconstruction of the mitral annulus. The remaining 39 patients (48%) received a mitral valve prosthesis (biological n = 20, mechanical n = 19). Retrospective analysis of preoperative, operative, and postoperative information of these 81 patients was performed. The follow-up period ranged between 4 and 10 years (mean follow-up, 5.8 ± 3.1).

Results: The 30-day mortality was 8.7% (n = 7). The actuarial survival rates at 5 years were 79% ± 3%. At the latest follow-up, 34 patients (55.7%) were in New York Heart Association class I, 23 (37.7%) were in class II, and 4 (6.5%) were in class III. The freedom from reoperation at 5 years was 90.5% ± 2%. There was only 1 stroke (1.6%), which occurred 1 year after the operation.

Conclusions: These results show that despite the increased perioperative risk and the difficult approach of the pathology in this patient group, decalcification and patch-reconstruction of the mitral annulus during mitral valve surgery can be performed safely with satisfactory and stable clinical midterm results.