Key result
Subvalvular techniques lower MR recurrence and improve remodeling vs standard restrictive annuloplasty, with similar mortality.
Why the study?
Do subvalvular techniques improve outcomes compared to standard restrictive annuloplasty in patients with ischaemic mitral regurgitation?
Systematic Review
Do subvalvular techniques improve outcomes compared to standard restrictive annuloplasty in patients with ischaemic mitral regurgitation?
Subvalvular techniques for ischemic mitral regurgitation repair may offer better leaflet tethering relief and lower recurrence of regurgitation compared to standard restrictive annuloplasty, with similar mortality.
Subvalvular techniques merit consideration in ischaemic mitral regurgitation repair; extends evidence beyond restrictive annuloplasty alone.
Subvalvular techniques are gaining ground as adjunct procedures for addressing ischaemic mitral regurgitation. The aim of this study was to describe the different techniques and assess their results. A systematic review of the literature was performed. The end points of interest were recurrence of mitral regurgitation, cardiac events and early and late echocardiographic measurements. After initial screening, 450 articles were identified, of which 24 provided the best available evidence on the topic. The different subvalvular techniques had similar mortality rates when compared with the standard restrictive annuloplasty. Recurrence of mitral regurgitation was of lower degree and the remodelling process was better for these techniques. Reoperation rates were also quite low. The subvalvular techniques showed superiority, addressing more successfully the leaflet tethering. However, larger randomized studies are needed to confirm these early positive results.
No takes yet. Share an insight, caveat, or question.
Athanasopoulos et al. (2017) conducted a systematic review in ischaemic mitral regurgitation. Subvalvular techniques vs. standard restrictive annuloplasty was evaluated on recurrence of mitral regurgitation, cardiac events and early and late echocardiographic measurements. Subvalvular techniques for ischaemic mitral regurgitation showed similar mortality but lower recurrence of mitral regurgitation and better remodelling compared with standard restrictive annuloplasty.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: