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Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction?
BACKGROUND: This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987923/ https://www.ncbi.nlm.nih.gov/pubmed/21059216 http://dx.doi.org/10.1186/1749-8090-5-107 |
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author | Qiu, Zhibing Chen, Xin Xu, Ming Jiang, Yingshuo Xiao, Liqiong Liu, LeLe Wang, Liming |
author_facet | Qiu, Zhibing Chen, Xin Xu, Ming Jiang, Yingshuo Xiao, Liqiong Liu, LeLe Wang, Liming |
author_sort | Qiu, Zhibing |
collection | PubMed |
description | BACKGROUND: This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which patients were predicted to benefit from mitral valve repair and which from replacement. METHODS: A total of 218 consecutive patients underwent either mitral valve repair (MVP, n = 112) or mitral valve replacement (MVR, n = 106). We retrospectively reviewed the clinical material, operation methods, echocardiography check during operation and follow-up. Patients details and follow-up outcomes were compared using multivariate and Kaplan-Meier analyses. RESULTS: No statistical difference was found between the two groups in term of intraoperative data. Early mortality was 3.2% (MVP 2.7% and MVR 3.8%). At discharge, Left ventricular end-systolic and end-diastolic diameter and left ventricular ejection fraction (LVEF) were improved more in the MVP group than MVR group (P < 0.05), however, in follow-up no statistically significant difference was observed between the MVR and MVP group (P > 0.05). Follow-up mitral regurgitation grade was significantly improved in the MVR group compared with the MVP group (P < 0.05). The Kaplan-Meier survival estimates at 1, 3, and 5 years were simlar between MVP and MVR group. Logistic regression revealed poor survival was associated with old age(#75), preoperative renal insufficiency and low left ventricular ejection fraction (< 30%). CONCLUSION: Mitral valve repair is the procedure of choice in the majority of patients having surgery for severe ischemic mitral regurgitation with left ventricular dysfunction. Early results of MVP treatment seem to be satisfactory, but several lines of data indicate that mitral valve repair provided less long-term benefit than mitral valve replacement in the LVD patients. |
format | Text |
id | pubmed-2987923 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29879232010-11-19 Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? Qiu, Zhibing Chen, Xin Xu, Ming Jiang, Yingshuo Xiao, Liqiong Liu, LeLe Wang, Liming J Cardiothorac Surg Research Article BACKGROUND: This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which patients were predicted to benefit from mitral valve repair and which from replacement. METHODS: A total of 218 consecutive patients underwent either mitral valve repair (MVP, n = 112) or mitral valve replacement (MVR, n = 106). We retrospectively reviewed the clinical material, operation methods, echocardiography check during operation and follow-up. Patients details and follow-up outcomes were compared using multivariate and Kaplan-Meier analyses. RESULTS: No statistical difference was found between the two groups in term of intraoperative data. Early mortality was 3.2% (MVP 2.7% and MVR 3.8%). At discharge, Left ventricular end-systolic and end-diastolic diameter and left ventricular ejection fraction (LVEF) were improved more in the MVP group than MVR group (P < 0.05), however, in follow-up no statistically significant difference was observed between the MVR and MVP group (P > 0.05). Follow-up mitral regurgitation grade was significantly improved in the MVR group compared with the MVP group (P < 0.05). The Kaplan-Meier survival estimates at 1, 3, and 5 years were simlar between MVP and MVR group. Logistic regression revealed poor survival was associated with old age(#75), preoperative renal insufficiency and low left ventricular ejection fraction (< 30%). CONCLUSION: Mitral valve repair is the procedure of choice in the majority of patients having surgery for severe ischemic mitral regurgitation with left ventricular dysfunction. Early results of MVP treatment seem to be satisfactory, but several lines of data indicate that mitral valve repair provided less long-term benefit than mitral valve replacement in the LVD patients. BioMed Central 2010-11-08 /pmc/articles/PMC2987923/ /pubmed/21059216 http://dx.doi.org/10.1186/1749-8090-5-107 Text en Copyright ©2010 Qiu et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Qiu, Zhibing Chen, Xin Xu, Ming Jiang, Yingshuo Xiao, Liqiong Liu, LeLe Wang, Liming Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title | Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title_full | Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title_fullStr | Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title_full_unstemmed | Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title_short | Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
title_sort | is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987923/ https://www.ncbi.nlm.nih.gov/pubmed/21059216 http://dx.doi.org/10.1186/1749-8090-5-107 |
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