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Öğe A Comparative Evaluation of Suture Techniques in Mitral Valve Replacement: Impact on Clinical Outcomes(Selçuk Üniversitesi, 2023 Ekim) Mola, Serkan; Yıldırım, Alp; Hasanzade, Sabir; Deniz, Gökay; Kasapoğlu, BurakObjective: This study aimed to compare the outcomes of mitral valve replacement (MVR) using the intermittent simple suture technique versus the horizontal matrix suture technique with pledgeted in terms of paravalvular leakage and infective endocarditis. Materials and Method: A retrospective analysis was conducted on 422 patients who underwent MVR between 2019 and 2023. Patients were divided into two groups based on the suture technique used: group B (simple suture technique) and group P (horizontal matrix suture technique with pledgeted). Propensity score matching was performed to balance the groups, resulting in 62 case pairs for comparative analysis. Results: There were no intraoperative mortalities, and the duration of cardiopulmonary bypass and cross-clamp time did not significantly differ between the two groups. No significant differences were observed in terms of total hospitalization time, early mortality, cerebrovascular events and arrhythmias. Postoperative echocardiography revealed minimal paravalvular leakage in both groups with non-serious leakage observed in four patients in group B and two patients in group P. The incidence of infective endocarditis was one in group B and two in group P. Hemolysis indicators showed higher mean values in the simple suture technique group although not statistically significant. Conclusion: The study findings suggest that there is no significant difference in the incidence of paravalvular leak and infective endocarditis between the intermittent simple suture technique and the horizontal matrix suture technique with pledgeted. Both techniques can be safely employed in MVR.Öğe Comparison of anterior mitral leaflet repair techniques with and without the use of chordal replacement in patients with degenerative mitral valve insufficiency(FORUM MULTIMEDIA PUBLISHING, LLC, 2019) Kadiroğulları, Ersin; Çiçek, Ömer Faruk; Mola, Serkan; Yaşar, Emre; Erkengel, İbrahim; Yalçınkaya, Adnan; Günertem, Eren; İkbaliafşar, Ferhat; Diken, Adem; Kocabeyoğlu, Sabit; Lafçı, Gökhan; Çağlı, KerimBackground: The aim of our study was to compare the outcome of patients who underwent mitral valve anterior leaflet repair with and without chordal replacement for degenerative mitral valve insufficiency. Methods: This study was conducted at our center between May 2006 and May 2013. The study included 125 patients with degenerative mitral valve insufficiency (64 males, 61 females; mean age 47 years, age range 16-78 years) who underwent mitral valve repair with anterior leaflet procedures. The patients were divided into 2 groups. Group A consisted of 56 patients with chordal replacement, and group B consisted of 69 patients with other repair techniques performed. Results: No significant difference was determined between the 2 groups in mortality, recurrence, and reoperation rates. The mortality rate was 3.6% in group A and 1.4% in group B. During the follow-up period, 3 patients were reoperated on (mitral valve replacement) because of severe mitral valve insufficiency. Two of these patients were from group A (3.6%), and the other was from group B (1.4%). One patient in group A underwent intraoperative mitral valve replacement after unsuccessful chordal replacement. Fifty patients (89.3%) in group A and 65 patients (94.2%) in group B exhibited no or mild recurrence of mitral valve insufficiency. Conclusion: Mitral valve repair in patients with degenerative mitral valve insufficiency resulting from anterior leaflet pathology is a safe procedure because of its durability and good long-term results. Despite the difficulty of the chordal replacement procedure, it may be used as an alternative technique for anterior mitral valve leaflet repair.Öğe Postoperative Outcomes of Mitral Valve Repair in Patients with Bileaflet Prolapse(Selçuk Üniversitesi, 2023 Nisan) Çiçek, Ömer Faruk; Mola, Serkan; Kadiroğulları, Ersin; Yalçınkaya, Adnan; Diken, Adem İlkay; Yaşar, Emre; Altıntaş, Garip; Ulaş, Mahmut; Lafçı, Gökhan; Çağlı, Kerim; Günertem, Orhan Eren; Erkengel, İbrahimBackground: Today, repair techniques almost completely take place of the mitral valve replacement, especially in patients with degenerative disease. Majority of the surgeons hesitate to prefer repair in patients with bileaflet prolapse. In this study we aimed to investigate postoperative results of our patients with mitral valve insufficiency due to bileaflet prolapse and treated with repair techniques. Methods: 89 patients who underwent mitral valve repair by the same surgical team due to bileaflet prolapse, between January 2006 and January 2016 in …………….. Hospital were included to this study. Preoperative, operative and postoperative data such as mortality, recurrent mitral insufficiency, echocardiographic chages and reoperation rates were investigated. Results: Mean follow up duration was 25.3±17.7 months. Mean age was 46.6±17.4. According to transthoracic echocardiographic evaluations, 8 (%9) patients had moderate and 81 (%91) patients had severe mitral insufficiency. When preoperative and postoperative values were compared, there was statistically significant improvement in functional capacity of patients according to NYHA classification. (2.1±0.5;1, p=0.001) Improvements in left ventricular end diastolic diameter(5.5±0.7 ; 5±0.6, p=0.001), left ventricular end sistolic diamete(3.8±0.6; 3.6±0.6, p=0.004 )r, left atrium diameter(4.8±0.9; 4.3±0.6, p=0.001) and pulmonary artery pressure (44.3±13.4; 32.1±5.4, p=0.001) were statistically significant. Conclusions: In the lights of findings about good postoperative results and durability rates, mitral valve repair can be safely used in patients with mitral valve insufficiency due to bileaflet prolapse especially with chordae replacement technique which can be feasible after improvements in suture technologies.
