| Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation. | |
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MedLine Citation:
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PMID: 15845559 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To examine the impact of pre-operative atrial fibrillation (AF) on the outcome of mitral valve repair (MVR) for degenerative mitral regurgitation (MR). METHODS AND RESULTS: Among 392 patients with moderate to severe MR who underwent MVR between 1991 and 2002, 283 patients with isolated degenerative MR were followed for 4.7+/-3.3 years. Of 27 deaths, nine were due to cardioembolic events and four were due to left ventricular (LV) dysfunction. When compared with patients with pre-operative AF, those with sinus rhythm (SR) had better survival (96+/-2.1 vs. 87+/-3.2% at 5 years, P=0.002) and higher cardiac event-free rates (96+/-2.0 vs. 75+/-4.4% at 5 years, P<0.001). In patients with pre-operative SR, observed and expected survival were similar (P=0.811). Cox multivariable regression analysis confirmed AF [P=0.027, adjusted hazard ratio (AHR) 2.9] and age as independently predictive of survival, and AF (P=0.002, AHR 3.1), New York Heart Association Class, and LV fractional shortening as independently predictive of cardiac event. CONCLUSION: Death due to LV dysfunction was not frequent and cardioembolic events due to AF were the leading cause for cardiac death. Pre-operative AF became a strong independent predictor of survival and morbidity. Patients with pre-operative SR had excellent prognosis. The benefits of preventing cardioembolic events due to AF validate the indication of MVR for patients with high risk for AF. |
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Authors:
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Kosei Eguchi; Eiji Ohtaki; Takayoshi Matsumura; Kaoru Tanaka; Tetsuya Tohbaru; Nobuo Iguchi; Kazuhiko Misu; Ryuta Asano; Masatoshi Nagayama; Tetsuya Sumiyoshi; Hitoshi Kasegawa; Saichi Hosoda |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2005-04-21 |
Journal Detail:
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Title: European heart journal Volume: 26 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-08-29 Completed Date: 2006-02-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1866-72 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Atrial Fibrillation / complications*, mortality Cause of Death Disease-Free Survival Female Follow-Up Studies Hospital Mortality Humans Male Middle Aged Mitral Valve / surgery* Mitral Valve Insufficiency / mortality, surgery* Preoperative Care Prognosis Recurrence Reoperation Ventricular Dysfunction, Left / etiology, mortality |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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