Transaortic Repair of the Mitral Valve in Patients Undergoing Aortic Valve Replacement


  • Orlando Santana
  • Kshamaya B. Panchamukhi
  • Roberto Grana
  • Ernest A. Traad



Objective: We retrospectively evaluated the results of edge-to-edge (Alfieri) repair of the mitral valve via a transaortic approach in patients undergoing aortic valve replacement (AVR) and who had significant mitral regurgitation (MR).

Methods: From July 2000 to June 2006, 13 patients underwent edge-to-edge repair of the mitral valve via a transaortic approach with concomitant AVR. Patients were considered eligible for the transaortic Alfieri repair if the preoperative transesophageal echocardiogram indicated that the MR jet originated in the middle portion (A2/P2 segments) of the mitral valve. A postoperative transesophageal echocardiogram and follow-up transthoracic echocardiograms were obtained.

Results: There was no operative mortality. There was a significant improvement in the median MR grade from 3 (interquartile range [IQR], 2-4) preoperatively to 1 (IQR, 1-1) postoperatively (P < .0001). The ejection fraction (EF) remained stable, with mean preoperative and postoperative EFs of 44.2% ± 14.9% and 46.27% ± 11.6%, respectively (P = .4). No mitral stenosis was noted in any of the patients following edge-to-edge repair. Follow-up transthoracic echocardiograms obtained at a mean of 12.5 months postoperatively (range, 1-34 months) showed a median MR grade of 1 (IQR, 1-2) with no worsening compared with immediately postoperatively (P = .4).

Conclusion: Transaortic edge-to-edge repair of the mitral valve in patients undergoing AVR is feasible. The postoperative improvement in MR was maintained at the midterm follow-up.


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How to Cite

Santana, O., Panchamukhi, K. B., Grana, R., & Traad, E. A. (2009). Transaortic Repair of the Mitral Valve in Patients Undergoing Aortic Valve Replacement. The Heart Surgery Forum, 12(6), E320-E323.