Document Detail


Surgery for chronic ischemic mitral regurgitation - which mitral intervention?
MedLine Citation:
PMID:  21615322     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Surgical management of ischemic mitral regurgitation is associated with higher operative mortality, increased morbidity and poorer long-term survival. Selection of the most appropriate surgical treatment to maximize survival could be challenging due to factors such as inconsistent usage of contemporary surgical techniques, inconsistent classification schemes for the entity, paucity of long-term data in order to compare alternatives and an absence of randomized trials of valve repair versus valve replacement. In addition, there is a lack of patient-reported outcome measures and functional data parameters that take into consideration the patient's perspective in refining the decision making of the therapeutic strategy. In fact, such trials are difficult and if they were to be conducted there would be a high risk of dubious conclusions owing to clustering of outcomes with surgical expertise. This article aims to review the options for surgical management of chronic ischemic mitral regurgitation. It also attempts to identify areas of future research in order to clarify which of these are of priority and will realistically seek for relevant answers. Mitral intervention in this patient group seems to improve survival, although it is dependent on producing a competent mitral apparatus. There is no convincing evidence that repair is superior to replacement, and there is the possibility that the literature has been biased against replacement as the treatment of choice.
Authors:
Michael O Murphy; Kamran Ahmed; Thanos Athanasiou
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  9     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  587-97     Citation Subset:  IM    
Affiliation:
Department of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, Praed Street, London, W2 1NY, UK.
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