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Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report

BACKGROUND: Papillary muscle rupture (PMR) is an infrequent but catastrophic complication after myocardial infarction (MI). Surgical procedure is considered the optimal treatment, despite high risk. However, the gold standard technique is still a major dilemma. Therefore, a meta-analysis was carried...

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Autores principales: Pala, Barbara, Romaniello, Antonella, Cristiano, Ernesto, D’Angelo, Adriano, Grimaldi, Maria Chiara, Figliuzzi, Ilaria, Tonelli, Euclide, Volpe, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273235/
https://www.ncbi.nlm.nih.gov/pubmed/35621090
http://dx.doi.org/10.5603/CJ.a2022.0046
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author Pala, Barbara
Romaniello, Antonella
Cristiano, Ernesto
D’Angelo, Adriano
Grimaldi, Maria Chiara
Figliuzzi, Ilaria
Tonelli, Euclide
Volpe, Massimo
author_facet Pala, Barbara
Romaniello, Antonella
Cristiano, Ernesto
D’Angelo, Adriano
Grimaldi, Maria Chiara
Figliuzzi, Ilaria
Tonelli, Euclide
Volpe, Massimo
author_sort Pala, Barbara
collection PubMed
description BACKGROUND: Papillary muscle rupture (PMR) is an infrequent but catastrophic complication after myocardial infarction (MI). Surgical procedure is considered the optimal treatment, despite high risk. However, the gold standard technique is still a major dilemma. Therefore, a meta-analysis was carried out to assess and provide an overview comparing mitral valve replacement (MVR) and mitral valve repair (MVr) for PMR post-MI. METHODS: A systematic literature search was performed. Data were extracted and verified using a standardized data extraction form. Meta-analysis was realized mainly using RevMan 5.4 software. RESULTS: From four observational studies 1640 patients were identified; 81% underwent MVR and 19% MVr. Operative mortality results were significantly higher in MVR group than the MVr group. MVR was performed under emergency conditions and patients admitted in cardiogenic shock or who required the use of mechanical cardiac support underwent MVR. MVr had shorter time of hospitalization and similar incidence of postoperative complications than MVR. No significant differences existed between the two procedures regarding cardiopulmonary bypass time. CONCLUSIONS: Mitral valve repair appears to be a viable alternative to MVR for post-MI PMR, given that it has lower operative mortality, shorter time of hospitalization and similar incidence of short-term postoperative complications than MVR. However, it needs to be pointed out that MVR was associated with the most critical clinical condition following PMR. There is uncertainty regarding the overall survival and improvement of the quality of life between the procedures. Nevertheless, further completed investigation is required.
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spelling pubmed-92732352022-07-12 Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report Pala, Barbara Romaniello, Antonella Cristiano, Ernesto D’Angelo, Adriano Grimaldi, Maria Chiara Figliuzzi, Ilaria Tonelli, Euclide Volpe, Massimo Cardiol J Clinical Cardiology BACKGROUND: Papillary muscle rupture (PMR) is an infrequent but catastrophic complication after myocardial infarction (MI). Surgical procedure is considered the optimal treatment, despite high risk. However, the gold standard technique is still a major dilemma. Therefore, a meta-analysis was carried out to assess and provide an overview comparing mitral valve replacement (MVR) and mitral valve repair (MVr) for PMR post-MI. METHODS: A systematic literature search was performed. Data were extracted and verified using a standardized data extraction form. Meta-analysis was realized mainly using RevMan 5.4 software. RESULTS: From four observational studies 1640 patients were identified; 81% underwent MVR and 19% MVr. Operative mortality results were significantly higher in MVR group than the MVr group. MVR was performed under emergency conditions and patients admitted in cardiogenic shock or who required the use of mechanical cardiac support underwent MVR. MVr had shorter time of hospitalization and similar incidence of postoperative complications than MVR. No significant differences existed between the two procedures regarding cardiopulmonary bypass time. CONCLUSIONS: Mitral valve repair appears to be a viable alternative to MVR for post-MI PMR, given that it has lower operative mortality, shorter time of hospitalization and similar incidence of short-term postoperative complications than MVR. However, it needs to be pointed out that MVR was associated with the most critical clinical condition following PMR. There is uncertainty regarding the overall survival and improvement of the quality of life between the procedures. Nevertheless, further completed investigation is required. Via Medica 2022-07-04 /pmc/articles/PMC9273235/ /pubmed/35621090 http://dx.doi.org/10.5603/CJ.a2022.0046 Text en Copyright © 2022 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Clinical Cardiology
Pala, Barbara
Romaniello, Antonella
Cristiano, Ernesto
D’Angelo, Adriano
Grimaldi, Maria Chiara
Figliuzzi, Ilaria
Tonelli, Euclide
Volpe, Massimo
Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title_full Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title_fullStr Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title_full_unstemmed Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title_short Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report
title_sort overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: a meta-analysis inspired by a case report
topic Clinical Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273235/
https://www.ncbi.nlm.nih.gov/pubmed/35621090
http://dx.doi.org/10.5603/CJ.a2022.0046
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