The Analysis of Left Ventricular Ejection Fraction after Minimally
Invasive Surgery for Primary Mitral Valve Regurgitation
Abstract
Background: Although minimally invasive mitral valve surgery (MIMVS) has
become the first choice for primary mitral regurgitation (MR) in recent
years, clinical evidence in this field is yet limited. The main focus of
this study was the analysis of preoperative (Pre), postoperative (Post)
and 1-year follow-up (Fu) data in our series of MIMVS in order to
identify factors that have an impact on the left ventricular ejection
fraction (LVEF) evolution after MIMVS. Methods: We reviewed the
perioperative and 1-year follow-up data from 436 patients with primary
MR (338 isolated MIMVS und 98 MIMVS combined with tricuspid valve
repair) to analyzed patients baseline characteristics, the change of LV
size, the postoperative evolution of LVEF and its factors, and the
clinical outcomes. Results: The overall mean value of EF slightly
decreased at 1-year follow-up (mean change of LVEF: -2.63±9.00%). A
significant correlation was observed for PreEF und EF evolution, the
higher PreEF the more pronounced decreased EF evolution (in all 436
patients; r= -0.54, p<0.001, in isolated MIMVS; r= -0.54,
p<0.001, in combined MIMVS; r= -0.53, p<0.001).
Statistically significant differences for negative EF evolution were
evident in patients with mild or greater tricuspid valve regurgitation
(TR) (in all patients; p<0.05, OR=1.64, in isolated MIMVS;
p<0.01, OR=1.93, respectively). Overall clinical outcome in
NYHA classification at 1 year was remarkably improved. Conclusions: Our
results suggest an excellent clinical outcome at 1 year, although mean
LVEF slightly declined over time. TR could be a predictor of worsened
FuEF in patients undergoing MIMVS.