Key result
Mitral valve surgery linked to reduced paroxysms of non-sustained VT at 5 years.
Why the study?
To evaluate the effect of MV repair and replacement on the incidence of ventricular arrhythmias and identify risk factors for their persistence in patients with MV prolapse and severe MR.
Does mitral valve surgery reduce ventricular arrhythmias in patients with mitral valve prolapse and severe mitral regurgitation?
Cohort (n=30)
No
Does mitral valve surgery reduce ventricular arrhythmias in patients with mitral valve prolapse and severe mitral regurgitation?
Mitral valve surgery for severe mitral regurgitation in patients with mitral valve prolapse significantly reduces the incidence of malignant ventricular arrhythmias, though preoperative LV dilation and myxomatous degeneration increase the risk of arrhythmia persistence.
Answers are grounded in this paper and cite their sources.
May reduce NSVT burden after surgery in MVP with severe MR; hypothesis-generating in small observational cohort and needs randomized confirmation.
Aim To evaluate the effect of mitral valve (MV) repair and replacement on the incidence of ventricular arrhythmias (VA) and to identify risk factors for the persistence of VA in patients with MV prolapse and severe mitral regurgitation (MR) during a mid-term follow-up.Material and methods A single-site observational, prospective study successively enrolled 30 patients (mean age, 55.2±9.9 years, 60% men) who underwent MV repair or replacement for severe MR due to MV prolapse or chordal avulsion. Transthoracic echocardiography and Holter monitoring were performed in all patients before and annually after surgery. A pathomorphological study of MV fragments excised during surgery was performed.Results During the five-year follow-up period (144 person-years), one case of sudden cardiac death outside a health care facility was recorded. MR severity progressed in three patients after MV repair. The total number of all VAs decreased during the follow-up period, with a significant decrease in the number of paroxysms of unstable ventricular tachycardia during the first two years after surgery. The presence of VA in the postoperative period was correlated with the severity of postoperative left ventricular (LV) remodeling: end-diastolic volume (EDV) (rs=0.69; p=0.005), LV ejection fraction (EF) (rs = -0.55; p=0.004) and severity of MV myxomatous alterations according to histological study data (rτ=0.58; p=0.045). The beta-blocker treatment did not influence the VA frequency and severity (rs= -0.18; p=0.69). According to a univariate regression analysis only EDV (p = 0.001), LVEF <50% (p = 0.003), and myxomatous MV degeneration (p = 0.02) were risk factors for persistent ventricular tachycardia in the postoperative period.Conclusion Surgical intervention on MV in patients with MV prolapse and severe MR decreased the number of cases of malignant VAs and was correlated with the postoperative changes in LV volume and function, as well as the severity of MV myxomatous alterations.
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Малев et al. (2023) conducted a cohort in Mitral valve prolapse with severe mitral regurgitation and ventricular arrhythmias (n=30). Mitral valve repair or replacement was evaluated on Incidence of ventricular arrhythmias (paroxysms of non-sustained ventricular tachycardia) (p=0.002). Mitral valve surgery in patients with prolapse and severe regurgitation significantly decreased the number of paroxysms of non-sustained ventricular tachycardia over a 5-year follow-up.
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