Mitral regurgitation surgery prognosis: Difference between revisions

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{{Mitral regurgitation surgery}}
{{Mitral regurgitation surgery}}
{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]


{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@perfuse.org]
==Overview==
The results of mitral valve repair are excellent in the centers that regularly perform this surgery. Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.


==Surgical Outcome==
==Surgical Outcome==
 
*The results of mitral valve repair are excellent in the centers that regularly perform this surgery.
The results of mitral valve repair are excellent in the centers that regularly perform this surgery.
*Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.
 
Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.


'''Valve repair versus valve replacement'''
'''Valve repair versus valve replacement'''
 
*Advantages of [[mitral valve repair]] include:<ref name="pmid9918527">{{cite journal| author=Tribouilloy CM, Enriquez-Sarano M, Schaff HV, Orszulak TA, Bailey KR, Tajik AJ et al.| title=Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. | journal=Circulation | year= 1999 | volume= 99 | issue= 3 | pages= 400-5 | pmid=9918527 | doi= | pmc= | url= }} </ref><ref name="pmid3769948">{{cite journal| author=Krayenbuehl HP| title=Surgery for mitral regurgitation. Repair versus valve replacement. | journal=Eur Heart J | year= 1986 | volume= 7 | issue= 8 | pages= 638-43 | pmid=3769948 | doi= | pmc= | url= }} </ref><ref name="pmid7850937">{{cite journal| author=Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL| title=Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. | journal=Circulation | year= 1995 | volume= 91 | issue= 4 | pages= 1022-8 | pmid=7850937 | doi= | pmc= | url= }} </ref><ref name="pmid9129898">{{cite journal| author=Lee EM, Shapiro LM, Wells FC| title=Superiority of mitral valve repair in surgery for degenerative mitral regurgitation. | journal=Eur Heart J | year= 1997 | volume= 18 | issue= 4 | pages= 655-63 | pmid=9129898 | doi= | pmc= | url= }} </ref><ref name="pmid11568020">{{cite journal| author=Mohty D, Orszulak TA, Schaff HV, Avierinos JF, Tajik JA, Enriquez-Sarano M| title=Very long-term survival and durability of mitral valve repair for mitral valve prolapse. | journal=Circulation | year= 2001 | volume= 104 | issue= 12 Suppl 1 | pages= I1-I7 | pmid=11568020 | doi= | pmc= | url= }} </ref><ref name="pmid12835220">{{cite journal| author=Thourani VH, Weintraub WS, Guyton RA, Jones EL, Williams WH, Elkabbani S et al.| title=Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. | journal=Circulation | year= 2003 | volume= 108 | issue= 3 | pages= 298-304 | pmid=12835220 | doi=10.1161/01.CIR.0000079169.15862.13 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12835220  }} </ref>
Advantages of [[Mitral valve repair]] include:
**Lower operative mortality rate
*Lower operative mortality rate <ref name="pmid9918527">{{cite journal| author=Tribouilloy CM, Enriquez-Sarano M, Schaff HV, Orszulak TA, Bailey KR, Tajik AJ et al.| title=Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. | journal=Circulation | year= 1999 | volume= 99 | issue= 3 | pages= 400-5 | pmid=9918527 | doi= | pmc= | url= }} </ref><ref name="pmid3769948">{{cite journal| author=Krayenbuehl HP| title=Surgery for mitral regurgitation. Repair versus valve replacement. | journal=Eur Heart J | year= 1986 | volume= 7 | issue= 8 | pages= 638-43 | pmid=3769948 | doi= | pmc= | url= }} </ref>
**Improves left ventricular ejection fraction [[EF]] and function
*Improves left ventricular ejection fraction [[EF]] and function <ref name="pmid7850937">{{cite journal| author=Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL| title=Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. | journal=Circulation | year= 1995 | volume= 91 | issue= 4 | pages= 1022-8 | pmid=7850937 | doi= | pmc= | url= }} </ref>.
**Preserves native heart valve and avoids the use of a prosthetic heart valve with its complications.
*Preserves native heart valve and avoids the use of a prosthetic heart valve with its complications.
**Has good overall outcome with good survival rates
*Has good overall outcome with good survival rates <ref name="pmid9129898">{{cite journal| author=Lee EM, Shapiro LM, Wells FC| title=Superiority of mitral valve repair in surgery for degenerative mitral regurgitation. | journal=Eur Heart J | year= 1997 | volume= 18 | issue= 4 | pages= 655-63 | pmid=9129898 | doi= | pmc= | url= }} </ref><ref name="pmid11568020">{{cite journal| author=Mohty D, Orszulak TA, Schaff HV, Avierinos JF, Tajik JA, Enriquez-Sarano M| title=Very long-term survival and durability of mitral valve repair for mitral valve prolapse. | journal=Circulation | year= 2001 | volume= 104 | issue= 12 Suppl 1 | pages= I1-I7 | pmid=11568020 | doi= | pmc= | url= }} </ref><ref name="pmid12835220">{{cite journal| author=Thourani VH, Weintraub WS, Guyton RA, Jones EL, Williams WH, Elkabbani S et al.| title=Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. | journal=Circulation | year= 2003 | volume= 108 | issue= 3 | pages= 298-304 | pmid=12835220 | doi=10.1161/01.CIR.0000079169.15862.13 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12835220  }} </ref>.
**Lower risk for [[endocarditis]]
*Lower risk for [[endocarditis]].
**Avoids long term use of [[anticoagulants]]
*Avoids long term use of [[anticoagulants]].


'''Mechanical versus Biological valves'''
'''Mechanical versus Biological valves'''


Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
*Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
[[Biological]] valves tend to fail over time <ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464  }} </ref>, but they have a lower risk of blood clots.
*[[Biological]] valves tend to fail over time, but they have a lower risk of blood clots.<ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Valvular heart disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Disease]]
[[Category:Cardiac surgery]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Cardiac surgery]]
[[Category:Surgical procedures]]
[[Category:Overview complete]]
[[Category:Overview complete]]
[[Category:Template complete]]
[[Category:Valvular heart disease]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 19:42, 30 January 2020
Intern
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]

Overview

The results of mitral valve repair are excellent in the centers that regularly perform this surgery. Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.

Surgical Outcome

  • The results of mitral valve repair are excellent in the centers that regularly perform this surgery.
  • Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.

Valve repair versus valve replacement

  • Advantages of mitral valve repair include:[1][2][3][4][5][6]
    • Lower operative mortality rate
    • Improves left ventricular ejection fraction EF and function
    • Preserves native heart valve and avoids the use of a prosthetic heart valve with its complications.
    • Has good overall outcome with good survival rates
    • Lower risk for endocarditis
    • Avoids long term use of anticoagulants

Mechanical versus Biological valves

  • Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
  • Biological valves tend to fail over time, but they have a lower risk of blood clots.[7][8]

References

  1. ↑ Tribouilloy CM, Enriquez-Sarano M, Schaff HV, Orszulak TA, Bailey KR, Tajik AJ; et al. (1999). "Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications". Circulation. 99 (3): 400–5. PMID 9918527.
  2. ↑ Krayenbuehl HP (1986). "Surgery for mitral regurgitation. Repair versus valve replacement". Eur Heart J. 7 (8): 638–43. PMID 3769948.
  3. ↑ Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL (1995). "Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis". Circulation. 91 (4): 1022–8. PMID 7850937.
  4. ↑ Lee EM, Shapiro LM, Wells FC (1997). "Superiority of mitral valve repair in surgery for degenerative mitral regurgitation". Eur Heart J. 18 (4): 655–63. PMID 9129898.
  5. ↑ Mohty D, Orszulak TA, Schaff HV, Avierinos JF, Tajik JA, Enriquez-Sarano M (2001). "Very long-term survival and durability of mitral valve repair for mitral valve prolapse". Circulation. 104 (12 Suppl 1): I1–I7. PMID 11568020.
  6. ↑ Thourani VH, Weintraub WS, Guyton RA, Jones EL, Williams WH, Elkabbani S; et al. (2003). "Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting". Circulation. 108 (3): 298–304. doi:10.1161/01.CIR.0000079169.15862.13. PMID 12835220.
  7. ↑ Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S (1993). "A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease". N Engl J Med. 328 (18): 1289–96. doi:10.1056/NEJM199305063281801. PMID 8469251.
  8. ↑ Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH (2000). "Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial". J Am Coll Cardiol. 36 (4): 1152–8. PMID 11028464.

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