PMID- 12694775
OWN - NLM
STAT- MEDLINE
DCOM- 20030814
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 23
IP  - 4
DP  - 2003 Apr
TI  - Mitral valve repair for degenerative disease: is pericardial posterior 
      annuloplasty a durable option?
PG  - 552-9
AB  - OBJECTIVE: Biological and prosthetic rings are available for supporting mitral 
      valve repair (MVR). Contrasting data are reported on the durability of 
      pericardial ring annuloplasty. This retrospective study was undertaken to assess 
      the durability of MVR for degenerative regurgitation with posterior annuloplasty 
      performed with glutaraldehyde-treated autologous pericardium. METHODS: From 
      August 1995 through December 2000, 133 patients underwent mitral repair for 
      degenerative regurgitation (86 men, age 62.9+/-11.5 years). Thirty patients 
      (22.6%) underwent combined coronary artery bypass graft and fourteen (10.5%) 
      underwent tricuspid annuloplasty. Associated aortic disease, previous cardiac 
      surgery and endocarditis were considered exclusion criteria. RESULTS: 
      Seventy-seven patients (57.9%) received a Carpentier-Edwards ring and 56 received 
      (42.1%) an autologous pericardium ring. Thirty-day mortality was 3.8%. Mean 
      follow-up, 98.3% complete, was of 35.6+/-18.7 months. Five-year freedom from 
      reoperation and recurrence of mitral regurgitation> or =3+/4+ was significantly 
      higher in the prosthetic ring group (90.1% - CL90%: 81.9-98.3%) compared with the 
      pericardial ring group (62.6% - CL90%: 43.1-82.1%; P=0.027). Prosthetic ring 
      implantation (P=0.004; RR=0.11) and preoperative New York Heart Association 
      (NYHA) class< or =II (P=0.011; RR=0.16) were independently related to a lower 
      risk of reoperation and recurrence of mitral regurgitation> or =3+/4+, by 
      multivariate analysis. Five-year overall survival was 91.4% (CL90%: 87.9.7-95%). 
      A higher preoperative left ventricular end-diastolic diameter (P=0.006; RR=1.17) 
      and the severity of associated coronary artery disease (P=0.021; RR=2.00) were 
      independent predictive factors for poor survival by multivariate analysis. 
      CONCLUSIONS: Posterior pericardial annuloplasty can jeopardize reproducibility 
      and durability of MVR for degenerative regurgitation.
FAU - Bevilacqua, Stefano
AU  - Bevilacqua S
AD  - Cardiac Surgery Department, National Research Council, Ospedale G. Pasquinucci 
      CNR-CREAS, Massa, Italy. bevilacqua@ifc.cnr.it
FAU - Cerillo, Alfredo Giuseppe
AU  - Cerillo AG
FAU - Gianetti, Jacopo
AU  - Gianetti J
FAU - Paradossi, Umberto
AU  - Paradossi U
FAU - Mariani, Massimiliano
AU  - Mariani M
FAU - Matteucci, Sacha
AU  - Matteucci S
FAU - Kallushi, Enkel
AU  - Kallushi E
FAU - Glauber, Mattia
AU  - Glauber M
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Echocardiography
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/pathology/*surgery
MH  - Mitral Valve Insufficiency/mortality/pathology/*surgery
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2003/04/16 05:00
MHDA- 2003/08/15 05:00
CRDT- 2003/04/16 05:00
PHST- 2003/04/16 05:00 [pubmed]
PHST- 2003/08/15 05:00 [medline]
PHST- 2003/04/16 05:00 [entrez]
AID - S1010794002008679 [pii]
AID - 10.1016/s1010-7940(02)00867-9 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2003 Apr;23(4):552-9. doi: 
      10.1016/s1010-7940(02)00867-9.