Document Detail


Comparison of recovery after mitral valve repair and replacement.
MedLine Citation:
PMID:  17467438     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We sought to examine the comparative improvement in health status after primary mitral valve repair versus replacement in patients with mitral valve regurgitation in a longitudinal setting. METHODS: We prospectively followed 267 patients with mitral valve regurgitation who underwent primary mitral valve repair (n = 163) and replacement (n = 104) between January 2002 and January 2005. Health status was evaluated at baseline and 1, 3, and 12 months after surgery with the validated short-form 36 and analyzed using generalized estimating equations with adjustment for propensity scores. RESULTS: Compared with patients undergoing mitral valve replacement, patients requiring valve repair were younger and more likely to be male. The probability of postsurgical readmission because of cardiac events was low and similar between the two treatment groups. New York Heart Association functional class was significantly improved after both procedures, with better improvement achieved by mitral valve repair (P < .01). For both treatment groups, scores for most of the short-form 36 domains were depressed at 1 month; however, after 3- and 12-month lags, dramatic improvements were achieved in most of the domains. Adjusted changes in the physical component score were similar between the two arms at each follow-up. For the mental component score, patients who underwent repair showed significant improvements compared with patients who underwent replacement at both 3 months (difference: 4.84 points, P = .005) and 12 months (difference: 5.92 points, P < .001). CONCLUSIONS: Our study suggests that after mitral valve surgery, there is significant improvement in New York Heart Association functional class and health status, especially in patients undergoing mitral valve repair.
Authors:
Liping Zhao; Paul Kolm; Michael A Borger; Zefeng Zhang; Cheryl Lewis; Grant Anderson; Claudine T Jurkovitz; A Michael Borkon; Robert H Lyles; William S Weintraub
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  133     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-30     Completed Date:  2007-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1257-63     Citation Subset:  AIM; IM    
Affiliation:
Christiana Care Health System, Newark, Del 19713, USA. lzhao@christianacare.org
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MeSH Terms
Descriptor/Qualifier:
Female
Health Status
Heart Valve Prosthesis Implantation*
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / surgery*
Outcome and Process Assessment (Health Care)
Quality of Life
Questionnaires

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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