PMID- 17882375
OWN - NLM
STAT- MEDLINE
DCOM- 20071213
LR  - 20221207
IS  - 0340-9937 (Print)
IS  - 0340-9937 (Linking)
VI  - 32
IP  - 6
DP  - 2007 Sep
TI  - [Mid-term results after stentless mitral valve replacement. Comparison to 
      conventional mitral valve replacement and mitral valve repair].
PG  - 499-505
AB  - PURPOSE: To evaluate the clinical results after stentless (SMV) in comparison to 
      mitral valve repair (MV-rep) and conventional mitral valve replacement (MVR) at 5 
      years. PATIENTS AND METHODS: From 08/1997 onward, 155 patients with degenerative 
      mitral valve (MV) disease received an SMV (n=53, 68+/-8 years, 37 female), MV-rep 
      (n=51, 69+/-9 years, 32 female), or MVR (n=51, 66+/-9 years, 32 female). The 
      underlying MV disease was stenosis in 13 (SMV)/1 (MV-rep)/4 (MVR), incompetence 
      in 13 (SMV)/50 (MV-rep)/30 (MVR), and combined lesion in 27 (SMV)/0 (MV-rep)/12 
      (MVR) patients, respectively. Preoperative New York Heart Association (NYHA) 
      functional class was 3.1+/-0.6 (SMV)/2.9+/-0.5 (MV-rep)/2.9+/-0.6 (MVR), 
      Euroscore 5.2+/-2.3 (SMV), 5.0+/-1.9 (Mv-rep), 4.8+/-2.6 (MVR), left ventricular 
      ejection fraction 60.5+/-10% (SMV)/57.3+/-13% (MV-rep)/58.7+/-13% (MVR), and 
      cardiac index 2.1+/-0.8/2+/-0.7/2+/-0.8 l/min/m2 (not significant). Follow-up 
      includes 64+/-18 months (21-89 months). RESULTS: Surgery was performed via 
      conventional sternotomy (32 SMV/20 MVR-rep/34 MVR) or right anterolateral 
      minithoracotomy (21/31/17). Cross-clamp duration was 81+/-33 (SMV)/58+/-24 
      (MV-rep)/54+/-23 min (MVR; p<0.05). Mean pressure gradients amounted to 
      4.8+/-1.9/3.6+/-1.7/4.3+/-1.4 mmHg, and valve opening areas to 
      2.5+/-0.6/3+/-0.9/2.6+/-0.9 cm2, respectively. In-hospital mortality was 1 
      (SMV)/2 (MV-rep)/5 (MVR) patients (p<0.05). During follow-up, repeat surgical 
      interventions were required in 6 (SMV)/2 (MV-rep)/3 (MVR) patients. 5-year 
      survival was 80.5+/-4.4% (SMV)/82.6+/-5.6% (MV-rep)/80.2+/-5.5% (MVR; not 
      significant); this was comparable to an age-matched normal population. 
      CONCLUSION: At 5 years, the SMV compares favorably with conventional standards 
      when taking the patients' risk profile into account. The SMV with its reliable 
      functional and hemodynamic outcome may be the mitral prosthesis of choice in 
      future.
FAU - Lehmann, Sven
AU  - Lehmann S
AD  - Klinik fur Herzchirurgie, Herzzentrum, Universitat Leipzig, Strumpellstrasse 39, 
      04289, Leipzig, Germany. sven.lehmann@med.uni-leipzig.de
FAU - Walther, Thomas
AU  - Walther T
FAU - Kempfert, Jorg
AU  - Kempfert J
FAU - Leontyev, Sergey
AU  - Leontyev S
FAU - Holzhey, David
AU  - Holzhey D
FAU - Rastan, Ardawan Julian
AU  - Rastan AJ
FAU - Falk, Volkmar
AU  - Falk V
FAU - Mohr, Friedrich Wilhelm
AU  - Mohr FW
LA  - ger
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - English Abstract
PT  - Journal Article
TT  - Mittelfristige Ergebnisse nach gerustfreiem Mitralklappenersatz: Vergleich zum 
      konventionellen Mitralklappenersatz und zur Mitralklappenrekonstruktion.
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
SB  - IM
MH  - Aged
MH  - Cardiovascular Surgical Procedures/*methods
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/*surgery
MH  - Plastic Surgery Procedures/*methods
MH  - Stents
MH  - Treatment Outcome
EDAT- 2007/09/21 09:00
MHDA- 2007/12/14 09:00
CRDT- 2007/09/21 09:00
PHST- 2006/07/12 00:00 [received]
PHST- 2007/05/07 00:00 [accepted]
PHST- 2007/09/21 09:00 [pubmed]
PHST- 2007/12/14 09:00 [medline]
PHST- 2007/09/21 09:00 [entrez]
AID - 10.1007/s00059-007-2867-5 [doi]
PST - ppublish
SO  - Herz. 2007 Sep;32(6):499-505. doi: 10.1007/s00059-007-2867-5.