Multidisciplinary decision-making in mitral valve disease

Autor: P. Segers, Jos G. Maessen, Jindrich Vainer, Emile C. Cheriex, Samuel Heuts, Jules R. Olsthoorn, S. A. F. Streukens, Sem M. M. Hermans, P. Sardari Nia
Přispěvatelé: MUMC+: MA Med Staf Artsass CTC (9), RS: CARIM - R2.12 - Surgical intervention, RS: Carim - Vessels, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, RS: CARIM - R2.01 - Clinical atrial fibrillation, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Cardiothoracale Chirurgie (3), CTC
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Netherlands Heart Journal, 27(4), 176-184. Bohn Stafleu van Loghum
Netherlands Heart Journal
ISSN: 1876-6250
1568-5888
DOI: 10.1007/s12471-019-1238-1
Popis: Background Although decision-making using the heart-team approach is apparently intuitive and has a class I recommendation in most recent guidelines, supportive data is still lacking. The current study aims to demonstrate the individualised clinical pathway for mitral valve disease patients and to evaluate the outcome of all patients referred to the dedicated mitral valve heart team. Methods All patients who were evaluated for mitral valve pathology with or without concomitant cardiac disease between 1 January 2016 and 31 December 2016 were prospectively followed and included. Patients were evaluated, and a treatment strategy was determined by the dedicated mitral valve heart team. Results One hundred and fifty-eight patients were included; 67 patients were treated surgically (isolated and concomitant surgery), 20 by transcatheter interventions and 71 conservatively. Surgically treated patients had a higher 30-day mortality rate (4.4%), which decreased when specified to a dedicated surgeon (1.7%) and in primary, elective cases (0%). This was also observed for major adverse events within 30 days. Residual mitral regurgitation >grade 2 was more frequent in the catheter-based intervention group (23.5%) compared to the surgical group (4.8%). Conclusion In conclusion, the implementation of a multidisciplinary heart team for mitral valve disease is a valuable approach for the selection of patients for different treatment modalities. Our research group will focus on a future comparative study using historical cohorts to prove the potential superiority of the dedicated multidisciplinary heart-team approach.
Databáze: OpenAIRE
Externí odkaz: