Mitral valve repair with the "respect" approach in dialysis-dependent patients: a single-center experience

Background: Morbidity and mortality risks in patients with end-stage renal disease (ESRD) undergoing mitral valve surgery are high; however, little is known regarding the risks and results of mitral valve repair in these patients. Methods: We retrospectively reviewed the clinical data of dialysis-dependent patients who underwent mitral valve repair with the "respect" approach between April 2012 and April 2015 in our institution. Results: All five identified patients survived and their data were included in the analysis. Follow-up ranged from 3 to 48 months with a median of 24 +/- 8.9 months. Patients' cardiac function improved postoperatively with two patients in New York Heart Association class I and three patients in class II. Three patients had no or trivial mitral valve regurgitation, two patients had mild regurgitation, and none had moderate or higher regurgitation. Left ventricular end diastolic volume decreased significantly: from 166.2 +/- 32.7 mL preoperatively to 123.1 +/- 24.5 mL postoperatively (P<0.001). Conclusions: With the "respect" approach, mitral valve repair in dialysis-dependent patients with prolapse of the posterior leaflet provided good and stable results; however, appropriate perioperative management was critical in these patients.