Document Detail


One thousand minimally invasive mitral valve operations: Early outcomes, late outcomes, and echocardiographic follow-up.
MedLine Citation:
PMID:  23353109     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The present study assessed the clinical and echocardiographic outcomes for 1000 patients undergoing minimally invasive mitral valve surgery. METHODS: The Brigham Cardiac Valve database was reviewed. From August 1996 to November 2011, 1000 patients had undergone minimally invasive mitral valve surgery (median follow-up, 7 years). Data on the surgical approach, complications, reoperations, and late survival were tabulated. Late echocardiographic data on the recurrence of mitral regurgitation after mitral repair in myxomatous disease were also collected. Survival, freedom from reoperation and recurrent mitral regurgitation (grade ≥ 3+) were evaluated with life tables and Kaplan-Meier analyses. RESULTS: The mean patient age was 57 years. Of the 1000 patients, 41% were women. Myxomatous degenerative disease was the predominant pathologic entity (86%). A lower hemisternotomy was the predominant surgical approach (75%). Mitral repair was performed in 923 patients and replacement in 77. Eight operative deaths (0.8%) occurred. A total of 44 patients with failed mitral repairs underwent reoperation, with 1 mitral valve replaced again on the same operative day for atrioventricular groove disruption. Nine failed repairs were repaired again (9/44 [20%]). A total of 106 late deaths occurred. The overall survival at 15 years was 79% ± 3%. Freedom from reoperation at 15 years was 90% ± 3% for repairs and 100% for replacements. Late echocardiograms were acquired for 615 of 815 eligible mitral repair patients with myxomatous disease (75%). Freedom from recurrent mitral regurgitation (grade ≥ 3+) at 1, 5, and 10 years was 99% ± 1%, 87% ± 2%, and 69% ± 4%, respectively. CONCLUSIONS: Minimally invasive mitral valve surgery is effective, with excellent late results. The durability of minimally invasive mitral valve repair compared favorably with conventional full sternotomy methods at late follow-up.
Authors:
R Scott McClure; Leonidas V Athanasopoulos; Siobhan McGurk; Michael J Davidson; Gregory S Couper; Lawrence H Cohn
Related Documents :
21889079 - Treatment strategies for patients with hyperdivergent class ii division 1 malocclusion:...
24527739 - An update on mortality and morbidity in patients with very low postoperative hemoglobin...
19403519 - Short-term response of macular oedema to intravitreal bevacizumab.
12095809 - Treatment of idiopathic subfoveal choroidal neovascular lesions using photodynamic ther...
19205489 - Vitrectomy alone versus vitrectomy with simultaneous intravitreal injection of triamcin...
23804859 - Outcome after two-patch repair of complete common atrioventricular canal defects in pat...
15981089 - Different proinflammatory cytokine serum pattern in neonate patients undergoing open he...
21610239 - Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearin...
8444959 - Treatment of ulnar nerve palsy at the elbow with a night splint.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  -     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Plasma membrane Ca2+ ATPase Atp2b1a Regulates Bone Mineralisation in Zebrafish.
Next Document:  Moderate altitude is not associated with adverse postoperative outcomes for patients undergoing bidi...