Mitral Valve Repair for Anterior/Bi-leaflet Versus Posterior Leaflet Degenerative Mitral Valve Disease: A Systematic Review and Meta-analysis.

Autor: Iqbal K; Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan., Haque IU; Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan., Shaikh VF; Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan., Rathore SS; Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India., Yasmin F; Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan., Iqbal A; Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan., Shariff M; Department of General Surgery, Mayo Clinic, Rochester, MN., Kumar A; Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH; Section of Cardiovascular Research, Heart, Vascular and Thoracic Department, Cleveland Clinic Akron General, Akron, OH., Stulak JM; Department of General Surgery, Mayo Clinic, Rochester, MN; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN. Electronic address: stulak.john@mayo.edu.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2022 Dec; Vol. 47 (12), pp. 101355. Date of Electronic Publication: 2022 Aug 12.
DOI: 10.1016/j.cpcardiol.2022.101355
Abstrakt: Mitral valve repair (MVr) secondary to degenerative anterior/bi-leaflet mitral valve disease is more challenging than posterior leaflet repair. However, conclusive evidence is needed to make decisions based on the outcomes rather than technical difficulties. This meta-analysis compares anterior/bi-leaflet MVr with isolated posterior leaflet repair in patients with mitral regurgitation (MR) due to degenerative mitral valve disease. The outcomes of interest were long-term (≥ 5 years) survival and freedom from re-operation and moderate-to-severe MR. Meta-analysis of 10 studies showed that there was no significant difference in long-term survival (risk ratio, RR: 1.00; 95% confidence interval, 95% CI 0.96-1.04), freedom from moderate-to-severe MR (RR: 0.95; 95% CI 0.87-1.03), and freedom from re-operation (RR: 0.96; 95% CI 0.90-1.02) between anterior/bi-leaflet MVr and posterior leaflet repair. As outcomes of anterior/bilateral repair were comparable with those of isolated posterior leaflet repair, our findings do not support the inclination towards replacement over repair for MR caused by anterior/bilateral degenerative mitral disease.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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