PMID- 27688670
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20161005
LR  - 20201001
IS  - 1016-7315 (Print)
IS  - 2212-5043 (Electronic)
IS  - 1016-7315 (Linking)
VI  - 28
IP  - 4
DP  - 2016 Oct
TI  - Mitral valve replacement for mitral stenosis: A 15-year single center experience.
PG  - 232-8
LID - 10.1016/j.jsha.2016.02.007 [doi]
AB  - OBJECTIVES: Mitral valve replacement with either a bioprosthetic or a mechanical 
      valve is the treatment of choice for severe mitral stenosis. However, choosing a 
      valve implant type is still a subject of debate. This study aimed to evaluate and 
      compare the early and late outcomes of mitral valve replacement [mechanical (MMV) 
      vs. bioprosthetic (BMV)] for severe mitral stenosis. METHODS: A retrospective 
      cohort study was performed on data involving mitral stenosis patients who have 
      undergone mitral valve replacement with either BMV (n = 50) or MMV (n = 145) 
      valves from 1999 to 2012. Data were collected from the patients' records and 
      follow-up through telephone calls. Data were analyzed for early and late 
      mortality, New York Heart Association (NYHA) functional classes, stroke, pre- and 
      postoperative echocardiographic findings, early and late valve-related 
      complications, and survival. Chi-square test, logistic regression, Kaplan-Meier 
      curve, and dependent proportions tests were some of the tests employed in the 
      analysis. RESULTS: A total of 195 patients were included in the study with a 
      30-day follow-up echocardiogram available for 190 patients (97.5%), while 103 
      (53%) were available for follow-up over the telephone. One patient died early 
      postoperatively; twelve patients died late in the postoperative period, six in 
      the bioprosthesis group and six in the mechanical group. The late mortality had a 
      significant association with postoperative stroke (p < 0.001) and postoperative 
      NYHA Classes III and IV (p = 0.002). Postoperative NYHA class was significantly 
      associated with age (p = 0.003), pulmonary disease (p = 0.02), mitral valve 
      implant type (p = 0.01), and postoperative stroke (p = 0.02); 14 patients had 
      strokes in the mechanical (9) and in the bioprosthetic (5) groups. NYHA classes 
      were significantly better after the replacement surgeries (p < 0.001). BMV were 
      significantly associated with worse survival (p = 0.03), worse NYHA 
      postoperatively (p = 0.01), and more reoperations (p = 0.006). Survival was 
      significantly better with MMV (p = 0.03). When the two groups were matched for 
      age and mitral regurgitation, the analysis revealed that BMV were significantly 
      associated with reoperations (p = 0.02) but not significantly associated with 
      worse survival (p = 0.4) or worse NYHA (p = 0.4). CONCLUSION: MMV replacement in 
      mitral stenosis patients is associated with a lower reoperation rate, but there 
      was no difference in survival compared with BMV replacement.
FAU - Al Mosa, Alqasem F
AU  - Al Mosa AF
AD  - King Saud bin Abdulaziz University for Health Sciences, College of Medicine, 
      Riyadh, aSaudi Arabia.
FAU - Omair, Aamir
AU  - Omair A
AD  - King Saud bin Abdulaziz University for Health Sciences, Medical Education, 
      Riyadh, bSaudi Arabia.
FAU - Arifi, Ahmed A
AU  - Arifi AA
AD  - Cardiac Clinical Research, Cardiac Surgery, Cardiac Sciences, King Abdulaziz 
      Cardiac Center, Ministry of National Guard, Riyadh, cSaudi Arabia.
FAU - Najm, Hani K
AU  - Najm HK
AD  - Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Ave/M41, Cleveland, 
      Ohio, 44195, dUnited States.
LA  - eng
PT  - Journal Article
DEP - 20160302
PL  - Saudi Arabia
TA  - J Saudi Heart Assoc
JT  - Journal of the Saudi Heart Association
JID - 9887261
PMC - PMC5034490
OTO - NOTNLM
OT  - Bioprosthetic valves
OT  - Mechanical valves
OT  - Mitral stenosis
OT  - Outcome
OT  - Valve replacement
EDAT- 2016/10/01 06:00
MHDA- 2016/10/01 06:01
PMCR- 2016/03/02
CRDT- 2016/10/01 06:00
PHST- 2015/10/01 00:00 [received]
PHST- 2016/02/02 00:00 [revised]
PHST- 2016/02/11 00:00 [accepted]
PHST- 2016/10/01 06:00 [entrez]
PHST- 2016/10/01 06:00 [pubmed]
PHST- 2016/10/01 06:01 [medline]
PHST- 2016/03/02 00:00 [pmc-release]
AID - S1016-7315(16)00009-9 [pii]
AID - 10.1016/j.jsha.2016.02.007 [doi]
PST - ppublish
SO  - J Saudi Heart Assoc. 2016 Oct;28(4):232-8. doi: 10.1016/j.jsha.2016.02.007. Epub 
      2016 Mar 2.