We have located links that may give you full text access.
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Surgical ventricular restoration plus mitral valve repair in patients with ischaemic heart failure: risk factors for early and mid-term outcomes†.
European Journal of Cardio-thoracic Surgery 2016 April
OBJECTIVES: To assess the early and mid-term outcomes and related predictors in a consecutive series of patients who underwent surgical ventricular restoration (SVR) combined with additional mitral valve (MV) repair.
METHODS: From January 2001 to October 2014, 626 patients underwent SVR; of these, 175 (28%, median age 65) had an additional MV repair. Anterior, inferior or diffuse remodelling was present in 124 (71%), 41 (23%) and 10 (6%) patients, respectively. The median ejection fraction was 30%, whereas mitral regurgitation grade was 3.3 ± 0.8. Multivariable logistic regression and Cox regression analyses were used to identify predictors of early and mid-term mortality.
RESULTS: Operative death occurred in 25 patients (14.3%). Independent predictors of early mortality were age, creatinine and ejection fraction score [odds ratio (OR) = 5.1, 95% confidence interval (CI) 2.5-10.3], previous stroke (OR = 8.0, 95% CI 1.5-44), unstable angina (OR = 8.8, 95% CI 1.5-53) and diffuse remodelling (OR = 5.8, 95% CI 1.02-33). Average follow-up was 42 ± 37 months. The actuarial survival rate of the whole patient population at 3, 5 and 8 years was 72 ± 4, 65 ± 4 and 45 ± 6%, respectively. Risk factors for late mortality were preoperative creatinine (OR = 2.6, 95% CI 1.5-4.4), previous implantation of cardioverter defibrillator (OR = 4.7, 95% CI 1.6-5.8), whereas the absence of angina at the time of surgery emerged as protective factor (OR = 0.46, 95% CI 0.23-0.89).
CONCLUSIONS: MV repair combined with SVR is a complex and challenging procedure that can be performed with acceptable early and mid-term results. Interestingly, angina features predict both early and late outcome, with unstable angina at the time of surgery being a predictor of poor early outcome and the absence of angina at surgery, a predictor of favourable outcome at mid-term follow-up.
METHODS: From January 2001 to October 2014, 626 patients underwent SVR; of these, 175 (28%, median age 65) had an additional MV repair. Anterior, inferior or diffuse remodelling was present in 124 (71%), 41 (23%) and 10 (6%) patients, respectively. The median ejection fraction was 30%, whereas mitral regurgitation grade was 3.3 ± 0.8. Multivariable logistic regression and Cox regression analyses were used to identify predictors of early and mid-term mortality.
RESULTS: Operative death occurred in 25 patients (14.3%). Independent predictors of early mortality were age, creatinine and ejection fraction score [odds ratio (OR) = 5.1, 95% confidence interval (CI) 2.5-10.3], previous stroke (OR = 8.0, 95% CI 1.5-44), unstable angina (OR = 8.8, 95% CI 1.5-53) and diffuse remodelling (OR = 5.8, 95% CI 1.02-33). Average follow-up was 42 ± 37 months. The actuarial survival rate of the whole patient population at 3, 5 and 8 years was 72 ± 4, 65 ± 4 and 45 ± 6%, respectively. Risk factors for late mortality were preoperative creatinine (OR = 2.6, 95% CI 1.5-4.4), previous implantation of cardioverter defibrillator (OR = 4.7, 95% CI 1.6-5.8), whereas the absence of angina at the time of surgery emerged as protective factor (OR = 0.46, 95% CI 0.23-0.89).
CONCLUSIONS: MV repair combined with SVR is a complex and challenging procedure that can be performed with acceptable early and mid-term results. Interestingly, angina features predict both early and late outcome, with unstable angina at the time of surgery being a predictor of poor early outcome and the absence of angina at surgery, a predictor of favourable outcome at mid-term follow-up.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app