Evaluation Of Mid-Term Clinical And Echocardiographic Outcomes Of Alfieri (Edge-To-Edge) Mitral Valve Repair

Abstract

Aim: The present study aimed to evaluate mid-term clinical and echocardiographic outcomesof the Alfieri edge-to-edge repair performed on patients with moderate to severe mitralregurgitation (MR).Methods: Thirty patients (mean age, 61.2±11.2 years; 18 males) with moderate to severe MRof different etiologies and a pulmonary artery pressure (PAP) of >40 mmHg who underwent aAlfieri repair between 2005 and 2011 were included. All patients were selected and followed bythe same surgical team and cardiologist. The Alfieri edge-to-edge repair with ring annuloplastywas performed. The patients were postoperatively evaluated in terms of degree of MR, functionalcapacity according to the New York Heart Association (NYHA) classification, PAP, left atrialdiameter (LAD), atrial fibrillation, ejection fraction (EF), risk of functional mitral stenosis,etiological factors, and mortality.Results: Postoperative NYHA class, MR and LAD values of the study patients were significantlybetter as compared to the preoperative values (p<0.001). The rate of patients with increasedmean PAP in the preoperative period significantly reduced in the postoperative period (70% vs.30%, p<0.001). Functional mitral stenosis developed in only one patient. Mortality was foundhigher in the patients with ischemic MR with higher NYHA functional class than in those withdegenerative or rheumatic MR.Conclusion: Mid-term outcomes of the Alfieri edge-to-edge repair with ring annuloplasty,particularly in degenerative mitral valve pathologies, are promising. Regression in symptoms,improvements in functional capacity and examination findings, and decrease in the degree ofMR, and the improvements in the echocardiographic findings including decrease in PAP andLAD values, and the absence of atrial fibrillation and thromboembolism are important clinicaloutcomes