Résumé Résultats à long tenne après plastie de la valve mitrale : Une analyse des facteurs de risque

Content Provider	Semantic Scholar
Author	Meyer, M. R. Ludwig Segesser, Von Hurni, Michel Stumpe, Frank Eisa, Karam Ruchat, Patrick
Copyright Year	2014
Abstract	Objective: Mitral valve repair is the gold standard to restore mitral valve function and is now known to have good long·term outcome. ln order to help perioperative decision making, we analyzed our collective to find independent risk factors affecting their outcome. Methods: We retrospectively studied our first 175 consecutive adult patients (mean age: 64 ± 10.4 years; 113 males) who underwent primary mitral valve repair associated with any other cardiac procedures between January 1986 and December 1998. Risk factors influencing reoperations and late survival were plotted in a uni· and multivariate analyses. Results: Operative mortalitywas 3.4% (6 deaths, 0-22nd postoperative day (POD)). Late mortality was 9.1 % (16 deaths, 3rd-125th POM). Reoperation was required in five patients. Kaplan-Meier actuariat analysis demonstrated a 96 ± 1% 1 ·year survival, 88 ± 3% 5·year survival and a 69 ± 8% 1 O·year survival. Freedom from reoperations was 99% at 1 year after repair, 97 ± 2% after 5 years and 88 ± 6% after 10 years. Multivariate analysis demonstrated that residual NYHA class Ill and IV ( p = 0.001, RR 4.55, 95% Cl: 1.8514.29), poor preoperative ejection fraction (p = 0.013, RR 1.09, 95% Cl: 1.02-1.18), functional MR (p = 0.018, RR 4.17, 95% Cl: 1.32-16.67), and ischemic MR ( p = 0.049, RR 3.13, 95% Cl: 1.01-10.0) were all independent predictors of la te death. Persistent mitral regurgitation at seventh POD (p = 0.005, RR 4.55, 95% Cl: 1.56-20.0), age below 60 (p = 0.012, RR 8.7, 95% Cl: 2.44-37.8), and absence of prosthetic ring (p = 0.034, RR 4.76, 95% Cl: 1. 79-33.3) were all independent risk factors for reoperation. Conclusions: Mitral valve repair provides excellent survival. However, long· term outcome can be negatively inf\uenced by perioperative risk factors. Risk of reoperation is higher in younger patients with a residual mitral regurgitation and without ring annuloplasty. © 2007 European Association for Cardio·Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://serval.unil.ch/resource/serval:BIB_0F23B08695CF.P001/REF
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article