OBJECTIVES: To assess through a retrospective multicenter analysis the postoperative results of mitral valve replacement (MVR) with small prosthesis (size 23-25). The impact of small prosthetic size at mitral position on postoperative outcome after MVR is unknown. METHODS: From January 1989 to December 2001, 285 patients (mean age 62±14 years, 23% male and 77% female) submitted to MVR with small artificial valves were identified from institutional databases. Surgery in emergency was required in 54 cases, re-operation in 61, and associated procedures in 68, respectively. Thirty-two patients had size-23 mitral prosthesis, whereas 253 patients had size-25 artificial valve. Mechanical valve was implanted in 243 patients, whereas 38 patients had a biological prosthesis. Preservation of the native valve (one or both leaflets) was accomplished in 114 patients. Postoperative survival, morbidity and functional capacity were assessed. Univariate and multivariate analysis were carried out to evaluate determinants of postoperative outcome. RESULTS: Follow up was complete, and 1112 patient-years were available for the analysis. There were 12 early and 41 late deaths (34 cardiac-related). Kaplan-Meyer estimation showed 91% survival at 2 years and 82% at 5 years. Significant improvement of functional capacity was observed postoperatively in the majority of the patients. Cardiac-related complications occurred in 102 patients (36 major events). At multivariate analysis only the use of biological valve was identified as independent predictor of unfavorable postoperative result. CONCLUSIONS: Mitral valve replacement with small prosthesis in adult patients has a favorable outcome. Further investigations are ongoing to elucidate whether patient/prosthesis mismatch at the mitral level affects the results of MVR.

Small prosthesis (size23-25) for mitral valve replacement. Analysis of postoperative outcome from a retrospective multicenter study / Lorusso, R; Gerometta, P; Russo, C; Casari, S; Navia, J; Garcia, M; Folliguet, T; Beghi, Cesare. - (2003). (Intervento presentato al convegno The 2nd Biennal Meeting of "The Society for Heart Valve Disease" tenutosi a Paris, France. nel 28 June- 1 July, 2003).

Small prosthesis (size23-25) for mitral valve replacement. Analysis of postoperative outcome from a retrospective multicenter study.

BEGHI, Cesare
2003-01-01

Abstract

OBJECTIVES: To assess through a retrospective multicenter analysis the postoperative results of mitral valve replacement (MVR) with small prosthesis (size 23-25). The impact of small prosthetic size at mitral position on postoperative outcome after MVR is unknown. METHODS: From January 1989 to December 2001, 285 patients (mean age 62±14 years, 23% male and 77% female) submitted to MVR with small artificial valves were identified from institutional databases. Surgery in emergency was required in 54 cases, re-operation in 61, and associated procedures in 68, respectively. Thirty-two patients had size-23 mitral prosthesis, whereas 253 patients had size-25 artificial valve. Mechanical valve was implanted in 243 patients, whereas 38 patients had a biological prosthesis. Preservation of the native valve (one or both leaflets) was accomplished in 114 patients. Postoperative survival, morbidity and functional capacity were assessed. Univariate and multivariate analysis were carried out to evaluate determinants of postoperative outcome. RESULTS: Follow up was complete, and 1112 patient-years were available for the analysis. There were 12 early and 41 late deaths (34 cardiac-related). Kaplan-Meyer estimation showed 91% survival at 2 years and 82% at 5 years. Significant improvement of functional capacity was observed postoperatively in the majority of the patients. Cardiac-related complications occurred in 102 patients (36 major events). At multivariate analysis only the use of biological valve was identified as independent predictor of unfavorable postoperative result. CONCLUSIONS: Mitral valve replacement with small prosthesis in adult patients has a favorable outcome. Further investigations are ongoing to elucidate whether patient/prosthesis mismatch at the mitral level affects the results of MVR.
2003
Small prosthesis (size23-25) for mitral valve replacement. Analysis of postoperative outcome from a retrospective multicenter study / Lorusso, R; Gerometta, P; Russo, C; Casari, S; Navia, J; Garcia, M; Folliguet, T; Beghi, Cesare. - (2003). (Intervento presentato al convegno The 2nd Biennal Meeting of "The Society for Heart Valve Disease" tenutosi a Paris, France. nel 28 June- 1 July, 2003).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2502039
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