Background: The purpose of this study is to compare mitral valve replacement (MVR) to anuloplasty (MAP) in patients with severe functional mitral regurgitation (FMR).
Methods: Data of 43 patients with significant chronic FMR who underwent mitral valve operations from November 1999 through May 2011 were retrospectively analyzed. This reference group included patients who underwent MVR (n = 18) and MAP (undersized restrictive annuloplasty, n = 25). The mitral valve is replaced sparing the continuity between mitral valve and subvalvular apparatus. All patients had severe FMR, and 71.4% had New York Heart Association (NYHA) III or IV symptoms of heart failure, and 20% had preoperative intraaortic balloon pumping (IABP) insertion. The MVR group had significantly higher risk patients with complex jet and advanced coaptation depth (13.3 +/- 2.1 versus 11.1 +/- 2.3 mm, p = 0.04).
Results: Hospital mortality was 9.3%. No statistical difference was found between the 2 groups in term of intraoperative data. Kaplan-Meier survival estimates at 1, 5 years was 82.6, 72.3% in MVR group, and 77.8, 69.7% in MAP group (p = 0.98). Freedom from Cardiac-related event at 5 years was 62.7% for MVR compared to 56.8 % for MAP (p = 0.75). At the last follow-up, recurrence of MR II or greater was present in 4 (14.8%) patients in the MAP group and only one patient required re-operation because of worsening heart failure. In multivariable analysis, independent predictor of increased cardiac-related event was associated with residual pulmonary hypertension (HR, 3.0: p = 0.021).
Conclusions: In high-risk patients with severe FMR. MVR seems to be a reasonable option.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Atrial Functional Mitral Regurgitation: Definition, Mechanisms, and Treatment Perspectives.
Curr Cardiol Rep
January 2025
Hasselt University, Faculty of Medicine and Life Sciences / Limburg Clinical Research Centre, Agoralaan, Diepenbeek, Belgium.
Purpose Of Review: This review aims to explore the complex interplay between atrial functional mitral regurgitation (AFMR), atrial fibrillation (AF), and heart failure with preserved ejection fraction (HFpEF). The goal is to define these conditions, examine their underlying mechanisms, and discuss treatment perspectives, particularly addressing diagnostic challenges.
Recent Findings: Recent research highlights the rising prevalence of AFMR, now accounting for nearly one-third of significant mitral regurgitation cases.
Automatic 4D mitral valve segmentation from transesophageal echocardiography: a semi-supervised learning approach.
Med Biol Eng Comput
January 2025
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Performing automatic and standardized 4D TEE segmentation and mitral valve analysis is challenging due to the limitations of echocardiography and the scarcity of manually annotated 4D images. This work proposes a semi-supervised training strategy using pseudo labelling for MV segmentation in 4D TEE; it employs a Teacher-Student framework to ensure reliable pseudo-label generation. 120 4D TEE recordings from 60 candidates for MV repair are used.
View Article and Find Full Text PDFEffect of additional dimensions and views in the echocardiographic determination of 3-dimensional left ventricular volume in myxomatous mitral valve disease in dogs.
J Vet Intern Med
January 2025
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Background: Left ventricular (LV) volumes can be calculated from various linear, monoplane, and multiplane echocardiographic methods, and the same method can be applied to different imaging views. However, these methods and their variations have not been comprehensively evaluated against real-time 3-dimensional echocardiography (RT3D).
Hypothesis/objectives: To identify the LV volumetric approaches that produce the least bias and the best agreement with RT3D, and to assess interoperator reproducibility between an experienced and an inexperienced operator.
A scoping review evaluating the current state of gut microbiota and its metabolites in valvular heart disease physiopathology.
Eur J Clin Invest
January 2025
Department of Cardiology, Bern University Hospital, Inselspital, Bern, Switzerland.
Background: The human microbiome is crucial in regulating intestinal and systemic functions. While its role in cardiovascular disease is better understood, the link between intestinal microbiota and valvular heart diseases (VHD) remains largely unexplored.
Methods: Peer-reviewed studies on human, animal or cell models analysing gut microbiota profiles published up to April 2024 were included.
Percutaneous Mitral Valve-in-Ring Procedure in a Case of Severe Mitral Regurgitation Repaired with a Surgical Flexible Ring: A Step-by-Step Description.
Turk Kardiyol Dern Ars
January 2025
Department of Cardiology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Türkiye.
Severe mitral regurgitation (MR) following surgical repair of the mitral valve poses a significant clinical challenge. Patients who have undergone surgery are typically at high risk for a second operation. This report details the case of a 54-year-old male who underwent aortic valve replacement and mitral valve repair using a 34-ring, 14 years prior.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!