| Durability and outcome of aortic valve replacement with mitral valve repair versus double valve replacement. | |
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MedLine Citation:
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PMID: 12537188 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to evaluate morbidity and mortality after double valve replacement (DVR) and aortic valve replacement with mitral valve repair (AVR + MVP). METHODS: From 1977 to 2000, 379 patients underwent DVR (n = 299) or AVR + MVP (n = 80). Actuarial survival and freedom from reoperation were determined by the Kaplan-Meier method. Potential predictors of mortality and reoperation were entered into a Cox multiple regression model. Propensity score was introduced for the multivariable regression modeling for adjustment of a selection bias. RESULTS: Survival 15 years after surgery was similar between the groups (DVR, 81% +/- 3%; AVR + MVP, 79% +/- 7%; p = 0.44). Freedom from thromboembolic event at 15 years was similar between the groups (p = 0.25). Freedom from mitral valve reoperation at 15 years was significantly better for the DVR group (54% +/- 5%) as compared with the AVR + MVP group (15% +/- 6%; p = 0.0006), primarily due to progression of mitral valve pathology and early structural deterioration of bioprosthetic aortic valve used for patients with AVR + MVP. After AVR + MVP, freedom from mitral reoperation at 15 years was 63% +/- 16% for nonrheumatic heart diseases, and 5% +/- 5% for rheumatic disease (p = 0.04). CONCLUSIONS: Although both DVR and AVR + MVP provided excellent survival, DVR with mechanical valves should be the procedure of choice for the majority of patients because of lower incidence of valve failure and similar rate of thromboembolic complications compared with AVR + MVP. MVP should not be performed in patients with rheumatic disease because of higher incidence of late failure. |
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Authors:
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Masaki Hamamoto; Ko Bando; Junjiro Kobayashi; Toshihiko Satoh; Yoshikado Sasako; Kazuo Niwaya; Osamu Tagusari; Toshikatsu Yagihara; Soichiro Kitamura |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 75 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-01-22 Completed Date: 2003-02-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 28-33; discussion 33-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Adult Aged Aortic Valve / surgery* Bioprosthesis Cardiac Surgical Procedures / mortality Female Heart Valve Diseases / surgery Heart Valve Prosthesis* Humans Male Middle Aged Mitral Valve / surgery* Postoperative Complications Reoperation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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