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Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes.

التفاصيل البيبلوغرافية
العنوان: Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes.
المؤلفون: Kalil RAK; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.; Surgery Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil., Belli KC; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Mattos MOT; Surgery Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil., Sffair RCE; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Santos SCS; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Fagundes VR; Surgery Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil., Abrahão RS; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Albrecht ÁS; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Sant'Anna JRM; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Prates PR; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Nesralla IA; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil., Pivatto Júnior F; Cardiovascular Surgery Service, Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.; Internal Medicine Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
المصدر: Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2021 Aug 06; Vol. 36 (4), pp. 476-483. Date of Electronic Publication: 2021 Aug 06.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Brazilian Society of Cardiovascular Surgery Country of Publication: Brazil NLM ID: 101677045 Publication Model: Electronic Cited Medium: Internet ISSN: 1678-9741 (Electronic) Linking ISSN: 01027638 NLM ISO Abbreviation: Braz J Cardiovasc Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: São Paulo, SP, Brasil : Brazilian Society of Cardiovascular Surgery, [2015]-
مواضيع طبية MeSH: Heart Valve Prosthesis Implantation* , Mitral Valve Annuloplasty* , Mitral Valve Insufficiency*/surgery, Humans ; Middle Aged ; Mitral Valve/surgery ; Reoperation ; Retrospective Studies ; Risk Factors ; Treatment Outcome
مستخلص: Introduction: Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes.
Methods: This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis.
Results: One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum followup was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P=0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P=0.049).
Conclusion: Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation.
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فهرسة مساهمة: Keywords: Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Mitral Valve/surgery; Risk Factors; Treatment Outcomes
تواريخ الأحداث: Date Created: 20210708 Date Completed: 20211011 Latest Revision: 20211027
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8522312
DOI: 10.21470/1678-9741-2020-0520
PMID: 34236815
قاعدة البيانات: MEDLINE
الوصف
تدمد:1678-9741
DOI:10.21470/1678-9741-2020-0520