PMID- 24370200
OWN - NLM
STAT- MEDLINE
DCOM- 20140428
LR  - 20220311
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 97
IP  - 3
DP  - 2014 Mar
TI  - Similar survival after mitral valve replacement or repair for ischemic mitral 
      regurgitation: a meta-analysis.
PG  - 758-65
LID - S0003-4975(13)02366-7 [pii]
LID - 10.1016/j.athoracsur.2013.10.044 [doi]
AB  - BACKGROUND: Ischemic mitral regurgitation (IMR) occurs in 20% of patients after 
      myocardial infarction. There is no agreement as to the best surgical option. With 
      no prospective randomized controlled trials available, our objective was to 
      perform a meta-analysis comparing replacement and repair. METHODS: A literature 
      search was performed in PubMed, EMBASE, Ovid, and Google Scholar. The following 
      keywords were included: "ischemic mitral regurgitation" and "repair or 
      replacement." Inclusion and exclusion criteria were used to reflect current 
      surgical practice (subvalvular preservation, ring annuloplasty). Primary outcomes 
      of interest were operative mortality and survival. Secondary outcomes analyzed 
      were change in ejection fraction (EF), left ventricular (LV) dimensions, New York 
      Heart Association (NYHA) class, reoperation rate, and 2+ or greater recurrence of 
      mitral regurgitation. RESULTS: Of 280 articles, only 12 satisfied all inclusion 
      and exclusion criteria. These articles included 2,508 patients, 64% of whom 
      received valve replacement. Operative mortality was lower after repair (odds 
      ratio [OR], 0.56; 95% confidence interval [CI], 0.38-0.85; p = 0.001); no 
      difference was found when only articles with patients operated on mainly after 
      1998 were included (OR, 0.70; 95% CI, 0.44 -1.12; p = 0.14). Survival was similar 
      (hazard ratio [HR], 0.86; 95% CI, 0.66-1.13; p = 0.28). No differences in EF, 
      ventricular dimensions, NYHA class, and reoperation were found. Regurgitation 
      recurrence was higher in the repair group (OR, 7.51; 95% CI, 3.7-15.23; p < 
      0.001). CONCLUSIONS: Mitral valve repair is associated with lower operative 
      mortality but higher recurrence of regurgitation in patients with ischemic mitral 
      regurgitation. No differences were found regarding survival, NYHA class, and 
      functional indicators.
CI  - Copyright (c) 2014. Published by Elsevier Inc.
FAU - Dayan, Victor
AU  - Dayan V
AD  - Centro Cardiovascular, Hospital de Clinicas, Facultad de Medicina, Montevideo, 
      Uruguay. Electronic address: victor_dayan@hotmail.com.
FAU - Soca, Gerardo
AU  - Soca G
AD  - Centro Cardiovascular, Hospital de Clinicas, Facultad de Medicina, Montevideo, 
      Uruguay.
FAU - Cura, Leandro
AU  - Cura L
AD  - Centro Cardiovascular, Hospital de Clinicas, Facultad de Medicina, Montevideo, 
      Uruguay.
FAU - Mestres, Carlos A
AU  - Mestres CA
AD  - Department of Cardiovascular Surgery, Hospital Clinico, University of Barcelona, 
      Barcelona, Spain.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20131225
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2014 Mar;97(3):765-6. PMID: 24580899
CIN - Ann Thorac Surg. 2015 Apr;99(4):1489-90. PMID: 25841848
CIN - Ann Thorac Surg. 2015 Apr;99(4):1490. PMID: 25841849
MH  - *Cardiac Surgical Procedures
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Mitral Valve Insufficiency/complications/*mortality/*surgery
MH  - Myocardial Ischemia/complications
MH  - Survival Rate
EDAT- 2013/12/29 06:00
MHDA- 2014/04/29 06:00
CRDT- 2013/12/28 06:00
PHST- 2013/07/11 00:00 [received]
PHST- 2013/10/10 00:00 [revised]
PHST- 2013/10/11 00:00 [accepted]
PHST- 2013/12/28 06:00 [entrez]
PHST- 2013/12/29 06:00 [pubmed]
PHST- 2014/04/29 06:00 [medline]
AID - S0003-4975(13)02366-7 [pii]
AID - 10.1016/j.athoracsur.2013.10.044 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2014 Mar;97(3):758-65. doi: 10.1016/j.athoracsur.2013.10.044. 
      Epub 2013 Dec 25.