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Nationwide cohort study of mitral valve repair versus replacement for infective endocarditis
| Content Provider | Scilit |
|---|---|
| Author | Lee, Hsiu-An Cheng, Yu-Ting Wu, Victor Chien-Chia Chou, An-Hsun Chu, Pao-Hsien Tsai, Feng-Chun Chen, Shao-Wei |
| Copyright Year | 2018 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery Objectives The feasibility and long-term outcomes of mitral valve (MV) repair in patients with infective endocarditis (IE) remain unclear. Methods Using Taiwan's National Health Insurance Research Database, we identified 1999 patients who underwent MV surgery for IE during 2000 to 2013. The patients were more likely to have undergone valve replacement (1575 patients; 78.8%) than valve repair (424 patients; 21.2%). After 1:1 propensity score matching, 352 patients in each group were included for analysis. Perioperative outcomes and late composite end points, comprising all-cause mortality, MV reoperation, any stroke, major bleeding, and readmission for heart failure, were compared. Results Patients who received MV repair had fewer perioperative complications, lower in-hospital mortality rates (6.3% vs 10.8%; P = .031), and lower risks of late mortality (hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.44-0.80), and composite end point (HR, 0.67; 95% CI, 0.52-0.87) during a mean follow-up of 4.8 years. Subgroup analysis revealed a trend in which the beneficial effect of MV repair was not apparent when surgeries were performed in hospitals within the lowest volume quartile (P for interaction = .091). In patients who underwent surgery during active IE, MV repair was also related to a lower rate of late mortality (HR, 0.64; 95% CI, 0.48-0.85). Conclusions Mitral repair for IE has better perioperative and late outcomes than mitral replacement. Mitral repair performed by an experienced team is recommended for IE patients instead of MV replacement whenever possible, even with an active infection status. |
| Related Links | http://www.jtcvs.org/article/S0022522318310511/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2018.04.064 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 4 |
| Volume Number | 156 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-04-20 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Mitral Valve Surgery Mitral Valve Repair Mitral Valve Replacement |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
