Repair of nonsevere rheumatic aortic valve disease during other valvular procedures: Is it safe?

Bernal, José Manuel López; Fernández-Vals, Mónica; Rabasa, José; Gutiérrez-García, Francisco; Morales, Carlos; Revuelta, José M.

doi:10.1016/s0022-5223(98)70413-1

Cited by 24 publications

(18 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our present policy for associated mild aortic disease is to wait, considering that the time of aortic replacement is unpredictable. 18,19 Figure 6. Survival in group operated at acute phase of rheumatic fever.…”

Section: Discussionmentioning

confidence: 99%

Long-Term (29 Years) Results of Reconstructive Surgery in Rheumatic Mitral Valve Insufficiency

Chauvaud

Fuzellier²,

Berrébi³

et al. 2001

Circulation

184

116

View full text Add to dashboard Cite

Background-Results of conservative surgery are well established in degenerative mitral valve (MV) insufficiency.However, there are controversies in rheumatic disease. This study is the evaluation of one center for rheumatic MV insufficiency based on a functional approach. Methods and Results-From 1970 to 1994, 951 patients with rheumatic MV insufficiency were operated on with the reconstructive techniques elaborated by Alain Carpentier. Aortic valve diseases were excluded. Mean age was 25.8 years (4 to 75), and sinus rhythm was present in 63%. The functional classification used was type I, normal leaflet motion, 71 patients (7%); type II, prolapsed leaflet, 311 patients (33%); and type III, restricted leaflet motion, 345 patients (36%). The combined lesion of prolapse of the anterior leaflet and restriction of the posterior was present in 224 patients (24%). Surgical techniques used were implantation of a prosthetic ring in 95%, shortening of the chords and leaflet enlargement with autologous pericardium, and commissurotomy. Hospital mortality rate was 2%. The mean follow-up was 12 years (maximum, 29 years): 8618 patients per year. Actuarial survival was 89Ϯ19% at 10 years and 82Ϯ18% at 20 years. The rate of thromboembolic events was 0.4% patients per year (33 events), with 3 deaths. Freedom from reoperation was 82Ϯ19% at 10 years and 55Ϯ25% at 20 years. The main cause (83%) of reoperation was progressive fibrosis of the MV. The actuarial rate of reoperation was 2% patients per year and was correlated to the degree of preoperative fibrosis. Conclusions-Conservative

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term (29 Years) Results of Reconstructive Surgery in Rheumatic Mitral Valve Insufficiency

Chauvaud

Fuzellier²,

Berrébi³

et al. 2001

Circulation

184

116

View full text Add to dashboard Cite

show abstract

“…121–123 Of the three surgical studies, the highest prevalence was in the study with the youngest population (mean age 12 years), 121 and the lowest prevalence was in the oldest population (mean age 40 years). 122 …”

Section: Rationale and Evidence For Criteriamentioning

confidence: 99%

World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline

et al. 2012

View full text Add to dashboard Cite

Over the past 5 years, the advent of echocardiographic screening for rheumatic heart disease (RHD) has revealed a higher RHD burden than previously thought. In light of this global experience, the development of new international echocardiographic guidelines that address the full spectrum of the rheumatic disease process is opportune. Systematic differences in the reporting of and diagnostic approach to RHD exist, reflecting differences in local experience and disease patterns. The World Heart Federation echocardiographic criteria for RHD have, therefore, been developed and are formulated on the basis of the best available evidence. Three categories are defined on the basis of assessment by 2D, continuous-wave, and color-Doppler echocardiography: ‘definite RHD’, ‘borderline RHD’, and ‘normal’. Four subcategories of ‘definite RHD’ and three subcategories of ‘borderline RHD’ exist, to reflect the various disease patterns. The morphological features of RHD and the criteria for pathological mitral and aortic regurgitation are also defined. The criteria are modified for those aged over 20 years on the basis of the available evidence. The standardized criteria aim to permit rapid and consistent identification of individuals with RHD without a clear history of acute rheumatic fever and hence allow enrollment into secondary prophylaxis programs. However, important unanswered questions remain about the importance of subclinical disease (borderline or definite RHD on echocardiography without a clinical pathological murmur), and about the practicalities of implementing screening programs. These standardized criteria will help enable new studies to be designed to evaluate the role of echocardiographic screening in RHD control.

show abstract

“…Tricuspid valve operations included Duran flexible annuloplasty in 68 patients, De Vega annuloplasty or segmental annuloplasty in 20, and commissurotomy in 65 (isolated commissurotomy in 7 and associated with annuloplasty in 58; Table 2). Aortic valve replacement was also performed in 25 patients (mechanical prosthesis in 7 and bioprosthesis in 18), and aortic valve repair with previously described techniques 6 was done in 30 patients.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…This is true for both the mitral valve and the tricuspid valve but is much more doubtful for repair of the aortic valve. 6 …”

mentioning

confidence: 99%

Combined Mitral and Tricuspid Valve Repair in Rheumatic Valve Disease

et al. 2010

View full text Add to dashboard Cite

show abstract

Repair of nonsevere rheumatic aortic valve disease during other valvular procedures: Is it safe?

Cited by 24 publications

References 20 publications

Long-Term (29 Years) Results of Reconstructive Surgery in Rheumatic Mitral Valve Insufficiency

Long-Term (29 Years) Results of Reconstructive Surgery in Rheumatic Mitral Valve Insufficiency

World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline

Combined Mitral and Tricuspid Valve Repair in Rheumatic Valve Disease

Contact Info

Product

Resources

About