Introduction
Since the emergence of percutaneous transcatheter mitral valve
edge-to-edge repair, there have been more and more concerns about and
understanding of mitral valve regurgitation.1,2According to the guideline for valve disease, there is consensus for
surgical correction of the valve with primary mitral valve regurgitation
because mechanical valve dysfunction can be fixed only by a mechanical
solution.3,4 On the other hand, secondary mitral
regurgitation is referred to as left ventricular disease, not valve
leaflet disease. Regurgitation itself is regarded as only one component
in this situation, and restoration of mitral valve competence is not
curative.4,5 However, the presence of even moderate
mitral regurgitation is associated with a worsened prognosis in ischemic
mitral valve regurgitation, which is a form of secondary mitral valve
regurgitation.6,7 Correction of secondary mitral
regurgitation seems to be beneficial.
The Mitra Clip (Abbott Vascular, Menlo Park, CA) has been proven to
improve survival and hospitalization for a certain subset of secondary
mitral valve regurgitation patients.2,8 The Mitra Clip
is less invasive than cardiac surgery, but it does not seem to offer
superior control of mitral regurgitation compared to the
surgery.9 Mitral valve surgery can provide greater
benefits in the postoperative course over the long-term if accomplished
without increasing perioperative mortality or morbidity.
Clarification of early and long-term results of surgical correction for
secondary mitral valve regurgitation is very important, especially in
patients with poor left ventricular function, because high surgical
mortality and morbidity rates are anticipated in this situation.
The purpose of this study was to
retrospectively investigate the operative and long-term results of
mitral valve surgery for secondary mitral regurgitation with poor left
ventricular function defined as left ventricular ejection fraction
(LVEF) ≤30%. As a sub-analysis, risk factors for long-term mortality
were also investigated.