Key result
Mitral valve replacement resulted in greater improvement in NYHA functional class from III to I at 30 days in patients with severe mitral regurgitation and mild mitral stenosis compared to isolated severe mitral regurgitation.
Why the study?
Medical management cannot prevent hemodynamic consequences of severe rheumatic MR in asymptomatic or minimally symptomatic patients, warranting assessment of progressive MR's impact on ventricular function to optimize surgical timing.
Does mitral valve replacement improve left ventricular function and symptoms differently in patients with severe rheumatic mitral regurgitation with versus without mild mitral stenosis?
Observational (n=30)
No
Does mitral valve replacement improve left ventricular function and symptoms differently in patients with severe rheumatic mitral regurgitation with versus without mild mitral stenosis?
Absolute Event Rate: 13% vs 6%
In patients with severe rheumatic mitral regurgitation, the presence of mild mitral stenosis is associated with better postoperative reverse remodeling and symptom improvement after mitral valve replacement compared to isolated severe mitral regurgitation.
Hypothesis-generating for differential remodeling in mixed rheumatic lesions; should not yet change MVR decisions pending randomized confirmation.
Introduction: Surgical correction is the fundamental strategy for severe rheumatic mitral regurgitation as (MR) as medical management for MR can not prevent the hemodynamic consequences of severe MR in the asymptomatic and minimally symptomatic subjects. The purpose of this study is to assess the impact of duration of progressive rheumatic MR on LVEF, PH, LV and right ventricular dysfunction and decide about the selection of optimal timing for surgical intervention in our patient population.
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Dasbaksi et al. (2020) conducted an observational in Severe rheumatic mitral regurgitation with and without mild mitral stenosis (n=30). Mitral Valve Replacement (MVR) vs. Isolated severe MR vs severe MR with mild MS was evaluated on Improvement of NYHA functional class from III to I at 30 days. Mitral valve replacement resulted in greater improvement in NYHA functional class from III to I at 30 days in patients with severe mitral regurgitation and mild mitral stenosis compared to isolated severe mitral regurgitation.
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