Prophylactic mitral reconstruction for mitral regurgitation

Smolens, Iva; Pagani, Francis D.; Deeb, G. Michael; Prager, Richard L.; Sonnad, Seema S.; Bolling, Steven F.

doi:10.1016/s0003-4975(01)02984-8

Cited by 25 publications

(20 citation statements)

References 14 publications

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“…Sousa et al (21) previously noted that the overall operative mortality in patients, who underwent MV repair for severe MR was 1.7%. More recently, operative mortality has been reported by other authors between 0 to 0.5% (15,22,23). In our series consisting of 100 consecutive cases, there was no procedurerelated or early mortality within 30 days after surgery.…”

Section: Discussionsupporting

confidence: 52%

Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients

Korkmaz

Onan²,

Demir³

et al. 2011

Anadolu Kardiyol Derg

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ÖZETAmaç: Mitral kapak tamiri günümüz kalp cerrahisinde mitral yetmezliğin her tipinde ilk seçenek olarak akla gelmelidir. Çalışmamızda ciddi mitral yetersizlik nedeniyle uygulanan mitral kapak tamirlerinin klinik sonuçlarını değerlendirdik. Yöntemler: Bu prospektif kohort çalışmada mitral kapak tamiri planlanan 103 hastamızın (61 erkek, 42 kadın) ortalama yaşı 53.2±14.8 idi. Mitral kapak patolojisi hastaların %86'sında yetmezlik ve %14'ünde karışık tipti. Yüz (%97.1) hastada tamir girişimi başarılı idi. Ek cerrahi girişim 57 (%57) hastada yapıldı, bunların 31'i koroner arter baypas ve 13'ü triküspit kapak tamiri şeklindeydi. Ameliyat sonrası erken (<30 gün) ve geç (>30 gün) dönem komplikasyonlar araştırıldı. Tüm hastalara taburcu olduklarında ve klinik takip sırasında ekokardiyografi yapıldı. Geç hayatta kalım ve tromboembolizm, endokardit, reoperasyon ve rezidüel ciddi mitral yetersizlikten gibi istenmeyen olaylardan bağımsız olma oranları Kaplan-Meier sağkalım analizi ile değerlendirildi. Bulgular: Erken mortalite görülmedi. Hastalar taburcu olduğunda yapılan ekokardiyografik değerlendirmede %89'unda hiç/eser yetersizlik ve %11'inde hafif (+1) yetersizlik saptandı. Geç mortalite 14. ayda renal yetersizlik nedeniyle sadece 1 hastada gözlendi. Hastalarımızın ortalama takip süresi 21.2±10.3 aydı. Takipler sırasında yapılan ekokardiyografik değerlendirmede hastaların %96'sında hiç ya da hafif yetersizlik gözlendi. Orta (+2) ABSTRACTObjective: Mitral valve repair has become the procedure of choice for almost every type of mitral regurgitation (MR) in the current surgical era. We assessed clinical outcomes of mitral valve repair in severe MR. Methods: In this prospective cohort study, 103 patients (61 male, 42 female, mean age 53.2±14.8 years), who were planned to undergo valve repair were included. Mitral valve pathology was regurgitant in 86% and mixed in 14% of patients. The intention to perform mitral repair was successful in 100 (97.1%) of patients. Concomitant procedures were performed in 57 (57%) patients including 31 coronary artery bypass grafting and 13 tricuspid valve repairs. After surgery, early (<30 days) and late (>30 days) complications were recorded. Postoperative echocardiography was performed in all patients at discharge and during clinical follow-up. Late survival and freedom from adverse events including thromboembolism, endocarditis, reoperation, and residual severe MR were estimated by using the Kaplan-Meier survival analysis.Results: There was no early mortality. Echocardiographic assessment of patients at discharge revealed no/trivial regurgitation in 89% and mild (1+) MR in 11% of all patients. Late mortality occurred in only one patient at 14 months because of renal failure. The mean follow-up period of patients was 21.2±10.3 months. Echocardiographic examination during follow-up revealed that mitral insufficiency was none or mild in 96% of patients. Three (3%) patients had moderate (2+) MR and were treated medically. Mitral insufficiency recurrence with severe (3+) regurgitation occurred...

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Section: Discussionsupporting

confidence: 52%

Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients

Korkmaz

Onan²,

Demir³

et al. 2011

Anadolu Kardiyol Derg

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“…Several groups advocate the indication of early surgery in these patients, even the asymptomatic ones, especially when there is ruptured or elongated tendinous chordae of posterior mitral leaflet, where the odds to undergo mitral valve repair is likely high, with fairly satisfactory published outcomes [24,25].…”

Section: Resultsmentioning

confidence: 99%

Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos

Brandão¹,

Guedes²,

Silva³

et al. 2007

Rev Bras Cir Cardiovasc

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“…The risks of surgery depend on which procedure is performed. Mitral valve repair has the best operative mortality [42] and an excellent long-term outcome [43], but is more difficult to perform than valvular replacement, and is limited to patients without significant valvular calcification. This procedure is more likely to be successful in posterior leaflet prolapse or with ruptured chordae tendinae, and less likely with anterior leaflet involvement, rheumatic disease, or ischemic disease [6].…”

Section: Mitral Regurgitationmentioning

confidence: 99%

Asymptomatic valvular disease: Who benefits from surgery?

Botkin¹,

Seth²,

Aurigemma

2005

Curr Cardiol Rep

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Routine physical examination and noninvasive imaging frequently lead to the diagnosis of valvular heart disease in asymptomatic patients. The decision to proceed to surgical repair or replacement is based on an informed evaluation of the risks of surgery versus those encountered with a nonoperative course. In determining whether symptoms are present, stress testing may be helpful, as many patients with significant valvular lesions have a tendency to limit their daily physical exertion to levels that do not provoke symptoms. The two most feared consequences of conservative management, sudden death and permanent myocardial damage, are rare in asymptomatic patients with severe aortic stenosis or regurgitation. Surgery for asymptomatic aortic stenosis is performed only for certain high-risk subsets of patients, including those with left ventricular dysfunction, ventricular arrhythmia, and critically small valves. Asymptomatic patients with aortic regurgitation and mitral regurgitation should undergo surgery if they have systolic dysfunction or marked ventricular enlargement.

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Prophylactic mitral reconstruction for mitral regurgitation

Cited by 25 publications

References 14 publications

Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients

Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients

Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos

Asymptomatic valvular disease: Who benefits from surgery?

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