Decalcification of the Mitral Annulus: Surgical Experience in 81 Patients

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.

Key words

Mitral valve surgery - decalcification - calcification - mitral annulus reconstruction

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