Mitral Valve Repair Versus Replacement in a Brazilian Heart Institute During COVID-19 Era

MP038 

Abstract Submission 

Fabrício Dinato (1), Pablo Pomerantzeff (2), C.Manuel Brandão (3), Elinthon Veronese (4), Giuliana Tomasiello (2), Fabio Jatene (5)

(1) Heart Institute University of São Paulo Medical School, São Paulo, Brazil, (2) Heart Institute University of São Paulo Medical School, São Paulo, SP, (3) Heart Institute University of São Paulo Medical School, São Paulo, NA, (4) Heart Institute - University of São Paulo Medical School, S�o Paulo, Brazil, (5) Instituto do Coração (Heart Institute), Medical School, University of Sao Paulo, Sao Paulo

Fabrício Dinato    -  Contact Me
Heart Institute University of São Paulo Medical School

Pablo Pomerantzeff    -  Contact Me
Heart Institute University of São Paulo Medical School

C.Manuel Brandão    -  Contact Me
Heart Institute University of São Paulo Medical School

Elinthon Veronese    -  Contact Me
Heart Institute - University of São Paulo Medical School

Giuliana Tomasiello    -  Contact Me
Heart Institute University of São Paulo Medical School

Fabio Jatene    -  Contact Me
Instituto do Coração (Heart Institute), Medical School, University of Sao Paulo

Fabrício Dinato    -  Contact Me
N/A

Objective: This study aimed to evaluate the outcomes of isolated and elective mitral valve (MV) repair versus MV replacement at Heart Institute - University of São Paulo Medical School during COVID-19 era.

Methods: We retrospectively searched our dedicated in-hospital database for patients referred to our institution for MV surgery during COVID-19 era between March 2020 and December 2022. Among 456 patients who underwent MV surgery, we identified 245 eligible patients for analysis. Redo surgery, urgent operative procedure and patients with other valve pathology or with coronary artery disease were excluded. Mitral valve repair was performed in most cases by "Double Teflon" technique which consists of a quadrangular resection of the posterior leaflet, annulus plication with pledgetted stitches, and leaflet suture. The procedures were performed by the same surgical team in a standard approach by median sternotomy with central cannulation, mild hypothermia and cold blood cardioplegia. Statistical analysis was performed with Fisher's Exact Test.

Results: A total of 243 patients underwent primary isolated elective MV surgery during COVID-19 pandemic period in our institution. A total of 61 patients (25.1%) underwent MV repair. The mean age of the entire cohort was 57.7 years (53.3 years for MV replacement vs 61.5 years for MV repair) and 67.5% were female. The mean Society of Thoracic Surgeons (STS) score was 1.48%. Overall in-hospital mortality for the entire cohort was 3.7% (9/243). In-hospital mortality for MV replacement was 5.2% (9/172) and there was no operative mortality for MV repair (5.2% versus 0%; p = 0.11).

Conclusion: This study indicates that primary elective MV surgery had low operative mortality during COVID-19 era. Although there was no significant difference in early survival between groups, MV repair showed a trend of lower operative mortality compared with replacement during COVID-19 pandemic period.

Degenerative Valve Disease