Introduction: Rheumatic heart disease remains a public health problem, especially in developing countries. The mitral valve (MV) is the main affected cardiac structure, requiring intervention in many cases. The discussion of which is the best option - repair or replacement - is still a controversy.

Objective: To compare the survival of patients with rheumatic MV submitted to replacement or repair.

Methods: We systematically reviewed the English literature through PubMed®, Literatura Latino-Americana e do Caribe em Ciências da Saúde (or LILACS), Scientific Electronic Library Online (or SciELO), and Google Scholar between January 2021 and February 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) methodology. Articles with a sample of at least 30 patients who underwent MV replacement or repair were included.

Results: Six studies including 2874 patients were analyzed. Most of the patients were female (2001; 69.6%) with a ratio of 2.3:1. The ages ranged from 11 to 66 years. The mean follow-up varied from six to 106 months. In the MV repair group, mortality was 2.5% (62 of 2473) and reoperation was 3.7% (93 of 2473), while in the MV replacement group, mortality was 8.2% (106 of 1291), and 3.6% (54 of 1475) of the patients required reoperation. The patient's survival was similar (85% for repair and 87% for replacement). The main complications post-MV repair or replacement were stroke (1.8%; 2.5%) and endocarditis (0.5%; 1.3%).

Conclusion: The MV repair had lower mortality and fewer complications compared to MV replacement. Reoperation rate and survival are similar.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828486PMC
http://dx.doi.org/10.21470/1678-9741-2023-0294DOI Listing

Publication Analysis

Top Keywords

mitral valve
8
repair replacement
8
group mortality
8
repair
7
replacement
7
patients
5
rheumatic mitral
4
valve surgery
4
surgery repair
4
repair replacement?
4

Similar Publications

Who are we bridging? Description of warfarin patients receiving injectable bridging therapy.

Thromb Res

March 2025

University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 South 2000 East, Salt Lake City, UT 84112, USA; University of Utah Health Thrombosis Service, 6056 Fashion Square Drive, Suite 2420, Murray, UT 84107, USA.

Purpose: The evidence guiding the decision to provide injectable anticoagulant bridging therapy during periods of subtherapeutic warfarin anticoagulation is sparse. This study aims to identify the types of patients currently bridged within an academic medical center's Thrombosis Service, to highlight patient populations for future study of bridging outcomes.

Methods: This descriptive cohort study included patients taking warfarin managed by University of Utah Health Thrombosis Service who received outpatient enoxaparin bridging between January 1 and December 31, 2022.

View Article and Find Full Text PDF

Intracardiac flow dynamics in mitral regurgitation: state of the art.

Eur Heart J Imaging Methods Pract

January 2025

Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128 Padova, Italy.

Intracardiac flow dynamics is a complex phenomenon interrelated with cardiac mechanics. Today, it can be evaluated non-invasively using various imaging modalities, including echocardiography, magnetic resonance imaging, and computed tomography. This review explores the effects of mitral regurgitation on blood flow dynamics inside the left ventricular and atrial cavities and emphasizes the disruption of normal flow dynamics caused by mitral regurgitation, leading to turbulent flow and increased energy dissipation.

View Article and Find Full Text PDF

Valvular calcification, developing either in the mitral or the aortic valve, is highly prevalent in patients suffering from chronic kidney disease (CKD), in whom their presence correlates with higher cardiovascular and all-cause mortality risk. To date, the exact mechanisms that promote heart valve calcification remain unclear, and none of the treatments tested so far have shown efficacy in preventing valvular fibrocalcific remodelling. It is therefore essential to improve our understanding of the mechanisms involved in the pathological process if we are to find new, effective therapies.

View Article and Find Full Text PDF

A unique presentation of systolic anterior motion of the mitral valve in a patient with obstructive hypertrophic cardiomyopathy and recurrent syncope: a case report.

Eur Heart J Case Rep

March 2025

Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, 127 Changle W Rd, Xi'an, Shaanxi 710032, China.

Background: Systolic anterior motion (SAM) of the mitral valve is a hallmark feature of hypertrophic obstructive cardiomyopathy (HOCM) and a primary cause of dynamic left ventricular outflow tract obstruction. This case report highlights an unusual presentation of SAM associated with acute haemodynamic collapse.

Case Summary: A 36-year-old male with HOCM presented with recurrent episodes of syncope.

View Article and Find Full Text PDF

Background: Currently, mitral valve replacement is the primary method of reintervention for patients with rheumatic heart disease (RHD) after percutaneous mitral balloon commissurotomy (PMBC). This study aims to investigate the feasibility of mitral valve repair in such patients and report its therapeutic outcomes compared to mitral valve replacement.

Methods: Data from patients with previous PMBC who underwent mitral valve surgery as disease progression between January 2011 and August 2023 were retrospectively analyzed.

View Article and Find Full Text PDF

Want 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!