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Thorac Cardiovasc Surg 2014; 62(01): 035-041
DOI: 10.1055/s-0033-1348919
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Results of Modern Mitral Valve Repair in Patients with Marfan Syndrome

Alexander Martin Bernhardt
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
*   Both authors contributed equally to this manuscript.
,
Hendrik Treede
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
*   Both authors contributed equally to this manuscript.
,
Christian Detter
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
Meike Rybczynski
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
Sara Sheikhzadeh
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
Florian Mathias Wagner
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
Yskert Von Kodolitsch
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
Hermann Reichenspurner
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

08 February 2013

21 May 2013

Publication Date:
09 July 2013 (online)

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Abstract

Objectives Mitral valve (MV) regurgitation is a common manifestation in patients with Marfan syndrome (MFS) and is age dependent. Valve pathology shares some features with myxomatous MV disease. Surgical treatment is still being debated and not well characterized in patients with MFS.

Patients and Methods We retrospectively evaluated the results of mitral valve repair (MVR) of symptomatic patients with MFS who underwent surgery between January 2004 and April 2011. MFS was diagnosed following the Ghent criteria. MVR was performed in 12 patients. Three patients underwent minimally invasive MVR despite severe thorax deformities. Mean follow-up was 60.1 months (95% CI: 48–72) and was complete.

Results Thirty-day mortality was 0%. One patient died because of arrhythmia 66 months after MVR. Transthoracic echocardiography at last visit showed mild mitral regurgitation in one patient (8.3%) and no mitral regurgitation in the remaining patients (91.7%).

Conclusion MVR was associated with excellent survival and a low rate of complications. Transthoracic echocardiography showed good results of the repaired valves even years later. Minimally invasive repairs are feasible even in deformed thoraces, lowering the risk for future aortic surgery. Because of excellent mid-term to long-term results, MVR may also be justified in asymptomatic Marfan patients.

Keywords

Marfan syndrome - mitral valve - mitral valve repair - minimally invasive - neochordae - artificial chordae
 

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