Document Detail


Mitral valve repair and replacement in northern New England.
MedLine Citation:
PMID:  12796763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The etiology of mitral valvular disease has changed in the last 20 years, and new techniques for the diagnosis and repair of mitral valves have been advanced. A retrospective regional study was conducted to identify changes in patient and disease characteristics and in population-based rates for mitral valve repair and replacement in northern New England. METHODS: Data from 1648 patients were collected from 5 clinical centers in Maine, New Hampshire, and Vermont between January 1, 1990, and December 31, 1999. U.S. Census data were used to calculate population-based rates. RESULTS: Total mitral valve procedures increased 2.4 times, from 8.7 to 20.6 cases/100,000/year (p(trend) = 0.004). Primary procedures increased from 6.7 to 16.9 cases/100,000/year (p(trend) = 0.014). Primary mitral valve repair procedures increased 3.7 times, from 2.4 to 8.9 cases/100,000/year (p(trend) = 0.012), whereas mitral valve replacement increased only 1.9 times, from 4.3 to 8.0 cases/100,000/year (p(trend) = 0.016). Repeat mitral valve operations did not change significantly (p(trend) = 0.810). During this period, there was a significant increase of the percentage of octogenarians (p(trend) = 0.016) and of patients with ejection fractions <40% (p(trend) = 0.012). There was a decrease in the percentage of patients with mitral stenosis (p(trend) = 0.024). CONCLUSION: In an era of a change in the etiology of mitral valvular disease and new techniques for diagnosis and repair of mitral valvular disease, regional data demonstrate substantial increased rates of mitral repair and replacement and expanded indications of older age and poorer left ventricular function.
Authors:
Edward R Nowicki; Ronald W Weintraub; Nancy J O Birkmeyer; John H Sanders; Lawrence J Dacey; Stephen J Lahey; Bruce Leavitt; Robert A Clough; Reed D Quinn; Gerald T O'connor
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  American heart journal     Volume:  145     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-10     Completed Date:  2003-06-16     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1058-62     Citation Subset:  AIM; IM    
Affiliation:
Departments of Surgery and Medicine, Dartmouth Medical College, Hanover, NH, USA. Edward.R.Nowicki@Dartmouth.EDU
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Health Transition*
Heart Valve Prosthesis / utilization*
Heart Valve Prosthesis Implantation / trends,  utilization*
Humans
Maine / epidemiology
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / epidemiology,  surgery
Mitral Valve Stenosis / epidemiology,  surgery
New Hampshire / epidemiology
Retrospective Studies
Stroke Volume
Vermont / epidemiology

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


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