Long-term results of surgical treatment of secondary severe mitral regurgitation in patients with end-stage heart failure: Advantage of prosthesis insertion.
Aged
Echocardiography
Female
Heart Failure
/ complications
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
/ adverse effects
Hospital Mortality
Humans
Male
Middle Aged
Mitral Valve
/ diagnostic imaging
Mitral Valve Annuloplasty
/ adverse effects
Mitral Valve Insufficiency
/ etiology
Prosthesis Design
Recovery of Function
Recurrence
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left
Chirurgie
Congestive heart failure
Insuffisance cardiaque
Insuffisance mitrale secondaire
Mitral valve repair
Mitral valve replacement
Remplacement valvulaire mitral
Réparation valvulaire mitrale
Secondary mitral regurgitation
Surgery
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
16
03
2018
revised:
15
06
2018
accepted:
05
09
2018
pubmed:
3
1
2019
medline:
23
4
2019
entrez:
3
1
2019
Statut:
ppublish
Résumé
Surgical treatment of secondary mitral regurgitation (SMR) is controversial. To analyse outcome after undersizing annuloplasty (UA) and mitral valve replacement (MVR). Consecutive patients operated on for severe SMR, with left ventricular ejection fraction (LVEF)<40% and refractory CHF, were included. Endpoints were in-hospital mortality, mid-term cardiovascular (CV) mortality, evolution of LV variables and recurrence of mitral regurgitation (MR). 59 patients were included (mean age 65±10 years, preoperative LVEF 36±6%; effective regurgitant orifice [ERO] 41±17 mm Surgical treatment of SMR can be performed with acceptable operative risk and mid-term survival in severe heart failure, even if there is no indication for revascularization. MVR is associated with significant reverse remodelling, and UA with prohibitive risk of MR recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Surgical treatment of secondary mitral regurgitation (SMR) is controversial.
AIM
OBJECTIVE
To analyse outcome after undersizing annuloplasty (UA) and mitral valve replacement (MVR).
METHODS
METHODS
Consecutive patients operated on for severe SMR, with left ventricular ejection fraction (LVEF)<40% and refractory CHF, were included. Endpoints were in-hospital mortality, mid-term cardiovascular (CV) mortality, evolution of LV variables and recurrence of mitral regurgitation (MR).
RESULTS
RESULTS
59 patients were included (mean age 65±10 years, preoperative LVEF 36±6%; effective regurgitant orifice [ERO] 41±17 mm
CONCLUSIONS
CONCLUSIONS
Surgical treatment of SMR can be performed with acceptable operative risk and mid-term survival in severe heart failure, even if there is no indication for revascularization. MVR is associated with significant reverse remodelling, and UA with prohibitive risk of MR recurrence.
Identifiants
pubmed: 30600216
pii: S1875-2136(18)30190-6
doi: 10.1016/j.acvd.2018.09.006
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
95-103Informations de copyright
Copyright © 2018. Published by Elsevier Masson SAS.