A comparison of the late results of replacement and of reconstructive procedures for acquired mitral valve disease

Wj, Kerth; Sharma, Geeta; Jd, Hill; Gerbode, Frank

doi:10.1016/s0022-5223(19)42270-8

Cited by 34 publications

(5 citation statements)

References 11 publications

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“…Salvador ve ark. [16] Bayazıt büzme-uçkur tekniğindeki gibi otolog perikard anuloplasti uygulanan 490 hastanın 15 yıllık izlemlerinde reoperasyonsuz yaşam oranını %93, Carpentier [15] Cosgrove, Stewart [7] Lessena [8] Galloway [9] Konstantinov [10] Duran [6] Antunes [11] Kerth [12] Oliviera [13] Orszulak [14] Çalışmamız Suri ve ark. [17] mitral onarım uyguladıkları 1.218 hastayı ortalama 11,5 yıl takip etmişler; mitral yetmezlik rekürensini %13.3, reoperasyon oranını %6,9 olarak bulmuşlardır.…”

Section: Discussionunclassified

“…Anuloplasti halkalarında anatomik yapıya uygun düzenlemeler liflet koaptasyonunu daha iyi hâle getirmiş, peroperatuar yetmezliğin transözofajiyal eko ile saptanması ve düzeltilmesi sonuçları olumlu etkilemiştir. Bu gelişmelerle birlikte, geçmiş dönemlerde uygulanan onarım tekniklerinin uzun dönem sonuçlarının da iyi olması uygun olgularda tercih edilebileceğini göstermektedir [5][6][7][8][9][10][11][12][13][14] .…”

Section: Discussionunclassified

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Assessment of the results of early and medium-term of mitral valve repairs

Yapıcı¹

2019

GKDA Derg

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/hasta yılı) olarak bulunmuştur ve bir olguda antikoagulana bağlı kanama saptanmıştır (%0.08/hasta yılı). Hastaların 5 yıl yaşam oranları %88±3 olarak bulunmuştur. Mitral onarım yapılan hastaların 8'inde gebelik ve başarılı doğum gerçekleşti. Farklı mitral onarım tekniklerinin erken-orta dönem mortalite, reoperasyon, tromboemboli açısından anlamlı farklılık oluşturmadığı saptandı (p>0.05). Yine anuloplasti ringi kullanılan ve kullanılmayan olguların karşılaştırılmasında fark saptanmamıştır (p=0,092). Sonuç: Romatizmal hastalık grubu ve doğurganlık dönemindeki kapak hastalarında; mitral kapak onarımı düşük hastane mortalitesi, iyi erken ve orta dönem sonuçlarıyla, özellikle akla gelmeli ve uygulanmalıdır. Onarım tekniğinin mortalite ve morbidite üzerinde etkisi bulunmasa dahi performans ve yaşam kalitesi konusunda ileri çalışmalara gerek vardır.

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Section: Discussionunclassified

Assessment of the results of early and medium-term of mitral valve repairs

Yapıcı¹

2019

GKDA Derg

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“…Sofern der Befund an der Mitralklappe zu einer Revision am offenen Herzen An laß gab, wurde die klappenerhaltende Rekonstruktion dem Mitralklappenersatz stets vorgezo gen. In einem beinahe gleich großen Beobachtungsgut von isolierten Mitralvitien aus den Jah ren 1961-1971 beschrieb Reed (15) 12,16,20) nach Mitralklappenersatz. Selbst wenn man von der sehr hohen Frühmortalität, die heute weitgehend zurückgedrängt worden ist, absieht, bleibt die Spätmor talität nach Mitralklappenersatz in diesem Beobachtungsgut gegenüber klappenerhaltender Ope ration um das Doppelte und mehr erhöht (Abb.…”

Section: Diskussionunclassified

“…Kombinier te Mitralvitien und die reine Mitralinsuffizienz können nur mit Hilfe extrakorporaler Zirkula tion unter direkter Sicht angegangen werden. Auch hier divergiert das Vorgehen an den ver schiedenen chirurgischen Zentren vom ausschließlichen Klappenersatz (2,5,20) zur Bevorzu gung klappenerhaltender Operationen, wo immer dies möglich erscheint (12,15,18,19). In der vorliegenden Studie wird das Zürcher chirurgische Patientengut mit Mitralklappenfeh lern der Jahre 1961-1971 in bezug auf die spezifische Läsion der Mitralklappe und auf den klinischen und hämodynamischen Schweregrad analysiert; ferner wird die Häufigkeit der An wendung der verschiedenen Operationsmethoden aufgezeigt und die damit erzielten Langzeit resultate durch Berechnung der Überlebenskurven untersucht.…”

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Mitralklappenchirurgie: Spätresultate bis 10 Jahre nach der Operation bei 501 Patienten*

Rothlin¹,

Bardos²,

Bj³

1975

Thorac cardiovasc Surg

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The results of mitral surgery between 1961 and 1971 are presented. Pure or predominant mitral stenosis outnumbered combined mitral valve disease and mitral incompetence by two to one. Surgical treatment comprised 291 closed mitral commissurotomies, 145 open reconstructions and 81 replacements of the mitral valve. One month mortality was 2,4% for commissurotomy, 4,8% for reconstruction, and 25% for replacement. Early mortality of the latter operation decreased to 7% since 1971. For patients with no more than slight preoperative symptoms life expectany remained unaffected for 10 years after closed commissurotomy. For patients with significant preoperative limitation or symptoms at rest 5 and 10 years life expectancy after successful surgery was 93 and 79% resp. for commissurotomy, 94 and 73% for reconstruction and 79 and 53% resp. for mitral valve replacement. In spite of a higher rate of reoperations and late deterioration of valve function the reparative operations deserve preference to the replacement of the mitral valve whenever feasible.

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“…Since thromboembolism and the complications of long-term anticoagulation are the major hazards to Presented at the XXVIIth Congress of the Socidt6 Internationale de Chirurgie, Kyoto, Japan, September [3][4][5][6][7][8]1977.…”

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confidence: 99%

Thrombotic complications after valve replacement with porcine heterografts

Hetzer

Gerbode

et al. 1979

World j. surg.

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The incidence of thrombotic and thromboembolic (TE) complications after Hancock valve replacement was reviewed in 140 patients with mitral valve prostheses and 150 patients with aortic valve prostheses. In patients with aortic valves, 1 embolus occurred and another patient was found at autopsy to have thrombi on a degenerated valve. Both patients had been on aspirin treatment. There was no TE event in patients receiving no anticoagulant therapy. In patients with mitral valves, 16 showed pre‐ and/or postoperative low output syndrome (Group A); 8 of these patients died and 6 had autopsies that showed major thrombi in the heterograft. In 126 long‐term survivors, 9 thromboembolic events occurred (TE incidence 5.4% per patient year). All patients with emboli had atrial fibrillation. The majority (7/9) of emboli occurred during the first 3 postoperative months. Five occurred in patients who were not on anticoagulation (Group B), and 2 occurred in patients receiving warfarin therapy (Group C). There was no thromboembolic event in patients receiving aspirin treatment (Group D). It is concluded that patients with Hancock aortic valves have a very small risk of TE, and do not need anticoagulation. Patients with Hancock mitral valves with stable hemodynamics have a decreased risk of TE and do not require anticoagulation. Patients with atrial fibrillation have an increased risk of TE and should be on warfarin for 3 months after surgery and then on aspirin therapy.

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A comparison of the late results of replacement and of reconstructive procedures for acquired mitral valve disease

Cited by 34 publications

References 11 publications

Assessment of the results of early and medium-term of mitral valve repairs

Assessment of the results of early and medium-term of mitral valve repairs

Mitralklappenchirurgie: Spätresultate bis 10 Jahre nach der Operation bei 501 Patienten*

Thrombotic complications after valve replacement with porcine heterografts

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