Document Detail


Long-term outcomes following repair or replacement in degenerative mitral valve disease.
MedLine Citation:
PMID:  20922625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We studied whether mitral valvuloplasty (MVP) was superior to mitral valve replacement (MVR) in patients with degenerative mitral regurgitation (MR), and analyzed the independent risk factors for survival and reoperation.
METHODS: 326 patients with degenerative MR underwent MVP (n = 241), mitral valve replacement (MVR) (n = 78) or emergent MVR due to failure of repair (EMVR). Clinical data were analyzed retrospectively.
RESULTS: Thirty-day mortality was lower after MVP (2.5 %) compared to MVR (9.0 %) ( P < 0.05). Late survival at 1 and 5 years in the MVP group was 94.4 % and 84.3 % versus 80.4 % and 64.6 % in the MVR group ( P < 0.05), respectively. After adjusting the baseline characteristics by the propensity score method, a significant survival benefit was found for patients who underwent MVP. Multivariable analysis showed that MVR was an independent predictor of thirty-day mortality and survival. There was no significant difference in thirty-day mortality and survival between the EMVR and MVR groups. The need for reoperation was not significantly different between the MVP and MVR groups. In the MVP group, the risk factors for survival and reoperation were identified.
CONCLUSIONS: MVP is superior to MVR for the treatment of degenerative MR despite the impact of repair failure. Age less than 60 years, ring size to body surface area greater than 19.0, absence of a prosthetic ring and residual MR at the end of surgery (≥ 1/4) reduce the durability of MVP.
Authors:
Y X Zhou; B Leobon; P Berthoumieu; D Roux; Y Glock; Y Q Mei; Y W Wang; G Fournial
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-10-04
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  58     ISSN:  1439-1902     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  415-21     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Service de Chirurgie Cardiovasculaire B, Centre Hospitalier Universitaire de Rangueil, Toulouse, France. zh_yongxin@yahoo.com.cn
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Chi-Square Distribution
Echocardiography, Doppler
Female
Heart Valve Prosthesis Implantation* / adverse effects,  mortality
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Mitral Valve / surgery*,  ultrasonography
Mitral Valve Annuloplasty* / adverse effects,  mortality
Mitral Valve Insufficiency / mortality,  surgery*,  ultrasonography
Propensity Score
Proportional Hazards Models
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

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


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