PMID- 22111338
OWN - NLM
STAT- MEDLINE
DCOM- 20120105
LR  - 20111124
IS  - 0021-5252 (Print)
IS  - 0021-5252 (Linking)
VI  - 64
IP  - 11
DP  - 2011 Oct
TI  - [Repair versus replacement of mitral valve for treating severe functional mitral 
      regurgitation].
PG  - 963-7
AB  - BACKGROUND: The purpose of this study is to compare mitral valve replacement 
      (MVR) to anuloplasty (MAP) in patients with severe functional mitral 
      regurgitation (FMR). METHODS: Data of 43 patients with significant chronic FMR 
      who underwent mitral valve operations from November 1999 through May 2011 were 
      retrospectively analyzed. This reference group included patients who underwent 
      MVR (n = 18) and MAP (undersized restrictive annuloplasty, n = 25). The mitral 
      valve is replaced sparing the continuity between mitral valve and subvalvular 
      apparatus. All patients had severe FMR, and 71.4% had New York Heart Association 
      (NYHA) III or IV symptoms of heart failure, and 20% had preoperative intraaortic 
      balloon pumping (IABP) insertion. The MVR group had significantly higher risk 
      patients with complex jet and advanced coaptation depth (13.3 +/- 2.1 versus 11.1 
      +/- 2.3 mm, p = 0.04). RESULTS: Hospital mortality was 9.3%. No statistical 
      difference was found between the 2 groups in term of intraoperative data. 
      Kaplan-Meier survival estimates at 1, 5 years was 82.6, 72.3% in MVR group, and 
      77.8, 69.7% in MAP group (p = 0.98). Freedom from Cardiac-related event at 5 
      years was 62.7% for MVR compared to 56.8 % for MAP (p = 0.75). At the last 
      follow-up, recurrence of MR II or greater was present in 4 (14.8%) patients in 
      the MAP group and only one patient required re-operation because of worsening 
      heart failure. In multivariable analysis, independent predictor of increased 
      cardiac-related event was associated with residual pulmonary hypertension (HR, 
      3.0: p = 0.021). CONCLUSIONS: In high-risk patients with severe FMR. MVR seems to 
      be a reasonable option.
FAU - Yoshida, Kazunori
AU  - Yoshida K
AD  - Department of Cardiovascular Surgery, Nishinomiya Watanabe Cardiovascular Center, 
      Nishinomiya, Japan.
FAU - Inoue, Takeshi
AU  - Inoue T
FAU - Munakata, Hiroshi
AU  - Munakata H
FAU - Minami, Hitoshi
AU  - Minami H
FAU - Oka, Takanori
AU  - Oka T
FAU - Okada, Kenji
AU  - Okada K
FAU - Okita, Yutaka
AU  - Okita Y
LA  - jpn
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Kyobu Geka
JT  - Kyobu geka. The Japanese journal of thoracic surgery
JID - 0413533
SB  - IM
MH  - Aged
MH  - Female
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - *Mitral Valve Annuloplasty
MH  - Mitral Valve Insufficiency/*surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2011/11/25 06:00
MHDA- 2012/01/06 06:00
CRDT- 2011/11/25 06:00
PHST- 2011/11/25 06:00 [entrez]
PHST- 2011/11/25 06:00 [pubmed]
PHST- 2012/01/06 06:00 [medline]
PST - ppublish
SO  - Kyobu Geka. 2011 Oct;64(11):963-7.