Practical experience and clinical results of reconstructive surgical correction of primary and secondary mitral regurgitation

Mitral regurgitation (MR) is the most common valvular anomaly worldwide, affecting more than 2 % of the population. Mitral valve surgery is indicated in symptomatic patients with severe insufficiency and asymptomatic individuals with left ventricular systolic dysfunction, pulmonary hypertension, or atrial fibrillation. Aim. Improving the immediate and long-term outcomes after cardiac surgery by demonstrating our own experience and analyzing the results of plastic correction for mitral regurgitation in patients with primary and secondary heart defects. Materials and methods. A single-center retrospective observational study of clinical data on 107 consecutive patients with mitral valve insufficiency who underwent a surgery at Zaporizhzhia Regional Clinical Hospital between 01.01.2020 and 31.12.2024 was conducted. Depending on clinical and etiological factors, the structure of patients with MR was defined as follows: primary MR – 47.66 % (n = 51), secondary MR – 52.34 % (n = 56) cases. The mean age of patients was 62.2 ± 11.2 years. The studied patients had a sex distribution of 40 (37.38 %) female and 67 (62.62 %) male individuals. Results. The length of stay in the intensive care unit was 4.6 ± 1.2 days. The total hospital length of stay was 17.4 ± 9.0 days. The hospital mortality rate for primary MR was 1.87 % (n = 2) and 7.48 % (n = 7) for secondary. At the time of discharge, 18.56 % (n = 18) of patients had no residual MR. In 51.54 % (n = 50) of patients, minimal (trivial) MR was detected, in 18.56 % (n = 18) – mild MR, and in 11.34 % (n = 11) – moderate MR. Thus, reconstructive plastic interventions on the MV were successfully performed in 90.65 % (n = 97) of patients. Freedom from reoperation in the early postoperative period was 100 %, freedom from moderate or severe MR in the early postoperative period was 88.66 % (86 out of 97 patients at the time of discharge). Conclusions. Modern surgical repair techniques for mitral valve reconstruction demonstrate highly effective and safe treatment of patients with primary and secondary mitral insufficiency. Transthoracic echocardiography is the most common and necessary powerful imaging method for the diagnosis of mitral regurgitation.