Long-term clinical outcome of mitral valve repair in asymptomatic severe mitral regurgitation☆☆☆
| Autor: | Bernhard Gerber, Patrick Montant, Gebrine El Khoury, Fabien Chenot, Jean-Louis Vanoverschelde, Agnes Pasquet, David Vancraeynest, Philippe Noirhomme |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Hypertension Pulmonary medicine.medical_treatment Asymptomatic Preoperative care Ventricular Dysfunction Left Postoperative Complications Recurrence Internal medicine Mitral valve Atrial Fibrillation Humans Medicine Aged Aged 80 and over Mitral regurgitation Mitral valve repair Ejection fraction business.industry Mitral Valve Insufficiency Atrial fibrillation General Medicine Middle Aged Prognosis medicine.disease Pulmonary hypertension Surgery Treatment Outcome medicine.anatomical_structure Cardiology Mitral Valve Female medicine.symptom Epidemiologic Methods Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 36:539-545 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2009.02.063 |
| Popis: | Objective: To assess the long-term survival, the incidence of cardiac complications and the factors that predict outcome in asymptomatic patients with severe degenerative mitral regurgitation (MR) undergoing mitral valve repair. Methods: Up to 143 asymptomatic patients (mean age 63+/-12 years) with severe degenerative MR who underwent mitral valve repair between 1990 and 2001 were subsequently followed up for a median of 8 years. The study population was subdivided into three subgroups: patients with left ventricular (LV) dysfunction and/or dilatation (n=18), patients with atrial fibrillation and/or pulmonary hypertension (n=44) and patients without MR-related complications (n=81). Results: For the patients, 10-year overall and cardiovascular survival was 82+/-4% and 90+/-3%. At 10 years, patients without preoperative MR-related complications had significantly better overall survival than patients with preoperative LV dysfunction and/or dilatation (89+/-4% vs 57+/-13%, log rank p=0.001). Patients without preoperative MR-related complications also tended to have a better 10-year overall and cardiovascular survival than patients with atrial fibrillation and/or pulmonary hypertension (overall survival of 79+/-8%), although this did not reach statistical significance (log rank p=0.17). Cox regression analysis identified the baseline left ventricular ejection fraction and age as the sole independent predictors of outcome. Conclusion: Our data indicate that in asymptomatic patients with severe degenerative MR, mitral valve repair is associated with an excellent long-term prognosis. Nonetheless, the presence of preoperative MR-related complications, in particular LV dysfunction and/or dilatation, greatly attenuates the benefits of surgery. This suggests that mitral valve repair should be performed early, before any MR-related complications ensue. |
| Databáze: | OpenAIRE |
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