Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients

Cen, Ye-Ying; Glower, Donald D.; Landolfo, Kevin P.; Lowe, James E.; Davis, Robert D.; Wolfe, Walter G.; Pieper, Carl F.; Peterson, Bercedis L.

doi:10.1067/mtc.2001.115418

Cited by 34 publications

(34 citation statements)

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“…Nevertheless, the statistics reported in Cen et al (2001) confirm that for physiological ejection fractions (in the range of 50 %), both the mechanical and the prosthetic valves perform adequately, while De Bacco et al (2009) reported that in mechanical mitral valve replacement, a low-ejection-fraction ventricle is one of the most negative prognostic factors. Both results are consistent with our findings.…”

Section: Discussionsupporting

confidence: 48%

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Flow structure in healthy and pathological left ventricles with natural and prosthetic mitral valves

Meschini

Tullio²,

Querzoli

et al. 2017

J. Fluid Mech.

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In this paper, the structure and the dynamics of the flow in the left heart ventricle are studied for different pumping efficiencies and mitral valve types (natural, biological and mechanical prosthetic). The problem is investigated by direct numerical simulation of the Navier-Stokes equations, two-way coupled with a structural solver for the ventricle and mitral valve dynamics. The whole solver is preliminarily validated by comparisons with ad hoc experiments. It is found that the system works in a highly synergistic way and the left ventricular flow is heavily affected by the specific type of mitral valve, with effects that are more pronounced for ventricles with reduced pumping efficiency. When the ventricle ejection fraction (ratio of the ejected fluid volume to maximum ventricle volume over the cycle) is within the physiological range (50 %-70 %), regardless of the mitral valve geometry, the mitral jet sweeps the inner ventricle surface up to the apex, thus preventing undesired flow stagnation. In contrast, for pathological ejection fractions ( 40 %), the flow disturbances introduced by the bileaflet mechanical valve reduce the penetration capability of the mitral jet and weaken the recirculation in the ventricular apex. Although in clinical practice the fatality rates in the five-year follow-ups for mechanical and biological mitral valve replacements are essentially the same, a breakdown of the deaths shows that the causes are very different for the two classes of prostheses and the present findings are consistent with the clinical data. This might have important clinical implications for the choice of prosthetic device in patients needing mitral valve replacement.

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Section: Discussionsupporting

confidence: 48%

“…In addition, Cen et al (2001) confirm that for ejection fractions in the range of 50 %, both the mechanical and the prosthetic valves perform adequately, while De Bacco et al (2009) state that an impaired ventricle is among the most negative prognostic factors for a mitral valve replacement with a mechanical prosthesis.…”

Section: Closing Remarksmentioning

confidence: 69%

Flow structure in healthy and pathological left ventricles with natural and prosthetic mitral valves

Meschini

Tullio²,

Querzoli

et al. 2017

J. Fluid Mech.

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“…Previous studies [27][28][29] have identified several independent predictors of survival in patients undergoing MVR; most of them also were found to be present in this study: older age and preoperative history of NYHA functional class IV, diabetes mellitus, renal failure, and heart failure. However, it must be emphasized that the influence of PPM was not analyzed in theses studies.…”

Section: Comparison With Previous Studiessupporting

confidence: 49%

Impact of Prosthesis-Patient Mismatch on Survival After Mitral Valve Replacement

et al. 2007

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Background-We recently reported that valve prosthesis-patient mismatch (PPM) is associated with persisting pulmonary hypertension after mitral valve replacement. Thus, the objective of this study was to evaluate the impact of PPM on mortality in patients undergoing mitral valve replacement. Methods and Results-The indexed valve effective orifice area was estimated for each type and size of prosthesis being implanted in 929 consecutive patients and used to define PPM as not clinically significant if Ͼ1.2 cm 2 /m 2 , as moderate if Ͼ0.9 and Յ1.2 cm 2 /m 2 , and as severe if Յ0.9 cm 2 /m 2 . Moderate PPM was present in 69% of patients; severe PPM was seen in 9%. For patients with severe PPM, 6-year survival (74Ϯ5%) and 12-year survival (63Ϯ7%) were significantly less than for patients with moderate PPM (84Ϯ1% and 76Ϯ2%; Pϭ0.027) or nonsignificant PPM (90Ϯ2% and 82Ϯ4%; Pϭ0.002). On multivariate analysis, severe PPM was associated with higher mortality (hazard ratio, 3.2; 95% confidence interval, 1.5 to 6.8; Pϭ0.003). Conclusions-Severe PPM is an independent predictor of mortality after mitral valve replacement. As opposed to other independent risk factors, PPM may be avoided or its severity may be reduced with the use of a prospective strategy at the time of operation. For patients identified as being at risk for severe PPM, every effort should be made to implant a prosthesis with a larger effective orifice area.

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“…Additional articles found through a citation search of the significant methods articles written about PS, using Science Citation Index, yielded 13 medical research studies that used PS in 2003 [163][164][165][166][167][168][169][170][171][172][173][174][175], 13 in 2002 [176][177][178][179][180][181][182][183][184][185][186][187][188], 11 in 2001 [189][190][191][192][193][194][195][196][197][198][199], 3 in 2000 [200][201][202], 1 in 1999 [203], 3 in 1998 [204][205][206], and a total of 3 before 1998 [207][208][209]. We present the number of studies with results based on PS methods published in each of these years in …”

Section: Resultsmentioning

confidence: 99%

A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods

Stürmer

Joshi

Glynn

et al. 2006

Journal of Clinical Epidemiology

577

497

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Comparison of survival after mitral valve replacement with biologic and mechanical valves in 1139 patients

Abstract: Choice of biologic or mechanical prosthesis does not significantly affect long-term patient survival after mitral valve replacement.

Cited by 34 publications

References 0 publications

Flow structure in healthy and pathological left ventricles with natural and prosthetic mitral valves

Flow structure in healthy and pathological left ventricles with natural and prosthetic mitral valves

Impact of Prosthesis-Patient Mismatch on Survival After Mitral Valve Replacement

A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods

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