Echocardiographic evaluation of non-surgically treated mild-to-moderate mitral dysfunction in patients undergoing aortic valve replacement.

Kim, Gwan Sic; Kim, Joon Bum; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won; Jung, Sung-Ho
Journal of cardiothoracic surgery
2019Jun ; 14 ( 1 ) :112.
저자 상세정보
Kim, Gwan Sic - Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
Kim, Joon Bum - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Choo, Suk Jung - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Chung, Cheol Hyun - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Lee, Jae Won - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Jung, Sung-Ho - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. csjung@amc.seoul.kr.
ABSTRACT
BACKGROUND: Surgical management of the mitral valve (MV) in patients with mild-to-moderate mitral dysfunction undergoing aortic valve replacement is still controversial. We investigated the echocardiographic data from patients with mild-to-moderate mitral dysfunction who did not undergo MV surgery. MATERIALS AND

METHODS: From January 1989 to June 2012, a total of 2731 patients underwent aortic valve replacement. Among these, 560 patients with mild-to-moderate mitral dysfunction were screened. Of these, 292 patients (61.9?짹?13.0?years; 113 females) who had not undergone MV surgery formed our study cohort. Survival, valve-related complication, and echocardiographic data were evaluated.

RESULTS: There were three early deaths. During the mean follow-up period of 56.9?짹?46.5?months, there were 23 late deaths and 28 valve-related complications. Valve-related event-free survival at 5 years was 85.9%?짹?2.4%. In serial postoperative echocardiographic evaluations (mean follow-up duration: 40.8?짹?44.5?months), 21 patients experienced a progression in late mitral dysfunction. At 5 years, 88.8%?짹?2.7% of patients did not suffer from late mitral dysfunction. Based on multivariate analysis, rheumatic pathology of MV (Hazard Ratio: 3.88, 95% confidence intervals 1.60-9.39, p?=?0.003) was an independent predictor of late mitral dysfunction.

CONCLUSIONS: Conservatively treated patients with mild-to-moderate mitral dysfunction exhibited acceptable clinical outcomes. Rheumatic pathology of MV is associated with a higher risk of progressive native MV dysfunction.
keyword
Aortic valve; Mitral valve; Replacement
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Rheumatic pathology of MV is associated with a higher risk of progressive native MV dysfunction
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
KCD코드
ICD 03
건강보험코드