What question did this study set out to answer?

To evaluate long-term left ventricular function using serial echocardiography after mitral valve repair versus replacement in patients with severe degenerative mitral regurgitation and baseline left ventricular systolic dysfunction.

April 11, 2005European Journal of Echocardiography

Mitral valve repair versus replacement for isolated non-ischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A long-term follow-up echocardiography study

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Why the study?

Does mitral valve repair improve long-term LV systolic indices compared to mitral valve replacement in patients with non-ischemic mitral regurgitation and preoperative LV dysfunction?

Population

45 patients with moderately severe or severe chronic degenerative non-ischemic mitral regurgitation and…

Comparison

Mitral valve repair (MVr) vs Mitral valve replacement (MVR)

Design

Cohort

Follow-up

6+/-3 years

Authors

NKN KOURISWestern Attica General Hospital IIIgnatios IkonomidisPreventive Cardiology DKD KONTOGIANNIGeneral Hospital of Nikea

Discussion

Member takes

Implication

MVr may preserve LV systolic function better than MVR long-term; leaves open need for RCTs in non-ischemic MR with preoperative dysfunction.

Key Points

To evaluate long-term left ventricular function using serial echocardiography after mitral valve repair versus replacement in patients with severe degenerative mitral regurgitation and baseline left ventricular systolic dysfunction.
Comparative cohort study evaluating 45 patients with moderate-to-severe or severe mitral regurgitation and preoperative ejection fraction ≤50%.
Patients were allocated to mitral valve repair (n=27, mean age 62±10 years) or mitral valve replacement (n=18, mean age 60±12 years).
Transthoracic echocardiography was performed preoperatively, postoperatively, and annually over a mean follow-up of 6±3 years.
Mitral valve repair induced significant and sustained postoperative decreases in left ventricular end-diastolic diameter (p<0.05) and end-systolic diameter (p<0.05), alongside improved velocity time integral (p<0.05).
Mitral valve replacement led to an initial decrease in end-diastolic diameter followed by a significant increase during follow-up (p<0.05), with persistently elevated end-systolic diameter and reductions in fractional shortening and ejection fraction (p<0.05).
During long-term follow-up, 5 deaths and 2 reoperations occurred in the repair group, compared to 6 deaths and 1 reoperation in the replacement group.

Structured PICO

Does mitral valve repair improve long-term LV systolic indices compared to mitral valve replacement in patients with non-ischemic mitral regurgitation and preoperative LV dysfunction?

Population

45 patients with moderately severe or severe chronic degenerative non-ischemic mitral regurgitation and preoperative EF <=50%. MVr group (n=27, 19 men, 8 women, aged 62+/-10 years) and MVR group (n=18, 8 men, 10 women, aged 60+/-12 years). Causes included myxomatous mitral valve disease, endocarditis, and degenerative mitral valves with ruptured chordae tendineae.

Intervention

Mitral valve repair (MVr)

Comparator

Mitral valve replacement (MVR)

Outcome

Left ventricular function (LVEDD, LVESD, VTI, FS, EF) evaluated by echocardiography during follow-upsurrogate

Mitral valve repair achieves better long-term preservation of LV systolic indices than mitral valve replacement in patients with non-ischemic mitral regurgitation and preoperative LV dysfunction.

Cite This Study

KOURIS et al. (2005) studied this question.

synapsesocial.com/papers/6a70a4f2e71d69abee08c01e https://doi.org/10.1016/j.euje.2005.01.003

Topics

Mitral valve intervention Echocardiography

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Implication

MVr may preserve LV systolic function better than MVR long-term; leaves open need for RCTs in non-ischemic MR with preoperative dysfunction.

Mitral valve repair versus replacement for isolated non-ischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A long-term follow-up echocardiography study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Mitral valve repair versus replacement for isolated non-ischemic mitral regurgitation in patients with preoperative left ventricular dysfunction. A long-term follow-up echocardiography study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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