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November 8, 2019Journal of Clinical TrialsOpen Access

Comparison of the Mortality Rates of Surgical Techniques for Correcting Atrioventricular Disjunction

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Why the study?

Left ventricular rupture is a rare but lethal complication of surgical mitral valve replacement, prompting a comparison of mortality rates between two surgical techniques for correcting atrioventricular disjunction.

Does a bovine pericardium patch technique reduce mortality compared to fixing the mitral annulus with bovine pericardial strips in patients with atrioventricular disjunction after mitral valve replacement?

Population

10 patients with atrioventricular disjunction among 720 undergoing mitral valve replacement

Comparison

Bovine pericardium patch covering the posterior LV wall vs mitral annulus fixation with bovine pericardial strips

Design

Single-center retrospective cohort study

Key result

Correction of atrioventricular disjunction using a bovine pericardium patch resulted in lower mortality (25%) compared to fixing the mitral annulus with pericardial strips (100%).

Authors

MSMarcelo Luiz Peixoto SobralAMAriadne Bonachela de MouraAVAugusto Hermes Colares de Souza Vasconcelos

Discussion

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Member takes

Overview

Patch technique may warrant study but should not yet change practice; leaves open need for randomized confirmation in atrioventricular disjunction.

Study Design

Type

Cohort (n=10)

Multicenter

No

Structured PICO

Does a bovine pericardium patch technique reduce mortality compared to fixing the mitral annulus with bovine pericardial strips in patients with atrioventricular disjunction after mitral valve replacement?

P
Population
10 patients who developed atrioventricular disjunction out of a cohort of 720 patients undergoing mitral valve replacement between 2005 and 2012.
E
Exposure
Group II technique: suturing a patch of bovine pericardium extending from the base of the lateral and medial papillary muscle, covering the posterior wall of the left ventricle, through the posterior mitral annulus, and ending in the posterior wall of the left atrium adjacent to the mitral ring.
C
Comparator
Group I technique: fixing the mitral annulus with bovine pericardial strips.
O
Outcome
Mortality ratehard clinical

Main Result

Absolute Event Rate: 25% vs 100%

A bovine pericardium patch technique covering the posterior wall of the left ventricle appears to significantly reduce mortality compared to simple annulus fixation with pericardial strips in patients experiencing atrioventricular disjunction after mitral valve replacement.

Cite This Study

Sobral et al. (2019) conducted a cohort in Atrioventricular disjunction after mitral valve replacement (n=10). Bovine pericardium patch sutured from papillary muscle base to posterior wall of left atrium (Group II technique) vs. Mitral annulus fixed with bovine pericardial strips (Group I technique) was evaluated on Mortality rate. Correction of atrioventricular disjunction using a bovine pericardium patch resulted in lower mortality (25%) compared to fixing the mitral annulus with pericardial strips (100%).

synapsesocial.com/papers/6a9acf71defc58a3ae9c79dchttps://doi.org/10.5281/zenodo.3590473
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