Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes
Abstract Introduction: Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenera...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2021-10-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000400476&tlng=en |
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| author | Renato A. K. Kalil Karlyse C. Belli Mariana O. T. de Mattos Rita de Cássia E. Sffair Sarah Ceolin Stein Santos Vitória Recuero Fagundes Rogério de Souza Abrahão Álvaro Schmidt Albrecht João Ricardo Michielin Sant'Anna Paulo Roberto Prates Ivo Abrahão Nesralla Fernando Pivatto Júnior |
| author_facet | Renato A. K. Kalil Karlyse C. Belli Mariana O. T. de Mattos Rita de Cássia E. Sffair Sarah Ceolin Stein Santos Vitória Recuero Fagundes Rogério de Souza Abrahão Álvaro Schmidt Albrecht João Ricardo Michielin Sant'Anna Paulo Roberto Prates Ivo Abrahão Nesralla Fernando Pivatto Júnior |
| author_sort | Renato A. K. Kalil |
| collection | DOAJ |
| description | Abstract Introduction: Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes. Methods: This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis. Results: One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum follow-up was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P=0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P=0.049). Conclusion: Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation. |
| first_indexed | 2024-04-10T09:05:08Z |
| format | Article |
| id | doaj.art-192cc6b0fd284eaaac506684e474f155 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-10T09:05:08Z |
| publishDate | 2021-10-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-192cc6b0fd284eaaac506684e474f1552023-02-21T07:33:31ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412021-10-0136447648310.21470/1678-9741-2020-0520Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for OutcomesRenato A. K. Kalilhttps://orcid.org/0000-0001-9084-129XKarlyse C. BelliMariana O. T. de MattosRita de Cássia E. SffairSarah Ceolin Stein SantosVitória Recuero FagundesRogério de Souza AbrahãoÁlvaro Schmidt AlbrechtJoão Ricardo Michielin Sant'AnnaPaulo Roberto PratesIvo Abrahão NesrallaFernando Pivatto JúniorAbstract Introduction: Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes. Methods: This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis. Results: One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum follow-up was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P=0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P=0.049). Conclusion: Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000400476&tlng=enMitral Valve/surgeryMitral Valve InsufficiencyMitral Valve AnnuloplastyRisk FactorsTreatment Outcomes |
| spellingShingle | Renato A. K. Kalil Karlyse C. Belli Mariana O. T. de Mattos Rita de Cássia E. Sffair Sarah Ceolin Stein Santos Vitória Recuero Fagundes Rogério de Souza Abrahão Álvaro Schmidt Albrecht João Ricardo Michielin Sant'Anna Paulo Roberto Prates Ivo Abrahão Nesralla Fernando Pivatto Júnior Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes Brazilian Journal of Cardiovascular Surgery Mitral Valve/surgery Mitral Valve Insufficiency Mitral Valve Annuloplasty Risk Factors Treatment Outcomes |
| title | Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes |
| title_full | Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes |
| title_fullStr | Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes |
| title_full_unstemmed | Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes |
| title_short | Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes |
| title_sort | valvuloplasty without prosthetic ring or band in patients with degenerative mitral regurgitation long term results and predictive factors for outcomes |
| topic | Mitral Valve/surgery Mitral Valve Insufficiency Mitral Valve Annuloplasty Risk Factors Treatment Outcomes |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000400476&tlng=en |
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