What is the clinical evidence from this study?

Study design: Cohort. Population: Degenerative mitral regurgitation with left ventricular systolic dysfunction (n=322). Intervention: Mitral valve repair. Primary outcome: Eight-year overall survival.

October 1, 2020Journal of Cardiothoracic SurgeryOpen Access

Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction: early and mid-term outcomes

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Key result

Mitral valve repair for degenerative MR with LVSD achieves ~97% eight-year survival.

n=322

Why the study?

To evaluate the early and mid-term outcomes of mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction.

Does mitral valve repair provide safe early and mid-term outcomes in patients with degenerative mitral regurgitation and left ventricular systolic dysfunction?

Study Design

Type

Cohort (n=322)

Multicenter

Structured PICO

Does mitral valve repair provide safe early and mid-term outcomes in patients with degenerative mitral regurgitation and left ventricular systolic dysfunction?

Population

322 patients with degenerative mitral regurgitation and left ventricular systolic dysfunction (defined as ejection fraction < 60% or left ventricular end-systolic dimension > 40 mm), mean age 52.7, 77.6% male. Excluded patients who underwent other concomitant procedures including aortic valve repair/replacement, coronary artery bypass graft, atrial fibrillation ablation, and congenital heart disease surgery.

Intervention

Mitral valve repair (primary techniques included leaflet resection, chordal reconstruction, and commissural closure) with an artificial annuloplasty band or ring routinely implanted in 99.1% of patients.

Outcome

Early and mid-term outcomes including in-hospital mortality, overall survival, freedom from reoperation for mitral valve, freedom from recurrent MR, and prognosis of left ventricular function during follow-up.hard clinical

Mitral valve repair can be safely performed in patients with degenerative mitral regurgitation and left ventricular systolic dysfunction, yielding excellent mid-term survival, though older age and worse baseline LV parameters predict postoperative LV deterioration.

Limitations

Observational and retrospective design
Single center experience
Poor compliance of some patients from remote areas affecting follow-up
Relatively short mean follow-up time
Follow-up rate negatively affected by poor compliance of some patients from remote areas
Approximately 25% of follow-up echocardiographic examinations were performed at other institutions and excluded from LV function analysis

Discussion

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Implication

Supports safe mitral valve repair in this population; leaves open need for randomized confirmation before changing practice.

Cite This Study

Li et al. (2020) conducted a cohort in Degenerative mitral regurgitation with left ventricular systolic dysfunction (n=322). Mitral valve repair was evaluated on Eight-year overall survival. Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction achieved an eight-year overall survival rate of 96.9%.

synapsesocial.com/papers/6a13da0df88db7183c597f5d https://doi.org/10.1186/s13019-020-01309-6

Topics

Mitral valve intervention

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Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction: early and mid-term outcomes

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction: early and mid-term outcomes

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider