Additional procedures
Edge-to-edge repair was performed in all patients in Group 2.
There were 25 cases with one edge-to-edge repair in Group 2 (4 cases
with edge-to-edge at anterior and posterior leaflets, 11 cases at
posterior and septal leaflets, 9 cases at anterior and septal leaflets,
and 1 case at posterior and posterior leaflets). There were 6 cases with
2 edge-to-edge repairs in Group 2 (3 cases with edge to edge at the
anterior-posterior leaflet and posterior-septal leaflet, 2 cases at the
anterior-septal leaflet and posterior-septal leaflet, and 1 case at the
anterior-septal leaflet and posterior-posterior leaflet). One patient in
Group 2 underwent three edge-to-edge repairs at the anterior-septal
leaflet, anterior-posterior leaflet, and posterior-septal leaflet.
In all patients in both groups, TR was controlled, confirmed by the
intraoperative saline test. The 1-week postoperative TR score in all 141
patients decreased, confirmed by echocardiography. TR score improved
from 1.6 ± 0.7 to 0.7 ± 0.32 (p<0.0001) in Group 1 and from
2.1 ± 0.78 to 0.88 ± 0.49 (p<0.0001) in Group 2.
Postoperative transthoracic echocardiographic data (Table 3)
All patients underwent transthoracic echocardiography 1 week after
surgery. There was no statistically significant difference in the
cardiac dimensions between the two groups. The postoperative TR score
(0.88 ± 0.49 vs. 0.7 ± 0.32; p=0.043) and the TRPG (24 ± 14 mmHg vs. 19
± 11 mmHg; p=0.05) were higher in Group 2 than in Group 1, respectively.
Predictors of additional procedures (Table 4)
Table 4 shows the results of the univariate and multivariate logistic
regression analyses to identify the predictors of the need for
additional procedures. In the model using echocardiographic data and
clinical data, the preoperative TR score (odds ratio, 1.8; 95%
confidence interval, 1.0–3.4; p=0.042) and the presence of a TV with
two posterior leaflets (odds ratio, 2.6; 95% confidence interval,
1.1–6.1; p=0.033) were independent predictors of additional procedures,
according to the multivariate analysis
Comparison of echocardiographic parameters for each number of
posterior leaflets (Table 5)
There was no significant difference between patients with one posterior
valve leaflet and patients with two posterior valve leaflets regarding
cardiac dimension in perioperative periods. Patients with two posterior
valve leaflets had better cardiac LV contraction than those with one
posterior valve leaflet before operation (58% ± 9.2% vs. 53% ± 12%,
respectively; p=0.014). There were also no significant differences in
the TRPG, the number of patients with pulmonary hypertension and the TV
diameter. However, the presence of two posterior valve leaflets was
associated with a higher preoperative TR score than one posterior valve
leaflet (1.9 ± 0.81 vs. 1.6 ± 0.67, respectively; p=0.032). Regarding
echocardiographic parameters after operation, there was no difference of
TR score just after surgery between groups, but two posterior leaflets
cases had higher TR score than one posterior leaflet cases one year
after operation (0.95 ± 0.43 vs. 0.7 ± 0.3, respectively; p=0.0075).