tailieunhanh - Báo cáo y học: "Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction? | Qiu et al. Journal of Cardiothoracic Surgery 2010 5 107 http content 5 1 107 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction Zhibing Qiu Xin Chen Ming Xu Yingshuo Jiang Liqiong Xiao LeLe Liu Liming Wang Abstract Background This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation IMR with left ventricular dysfunction LVD . Specifically we sought to determine whether the choice of mitral valve procedure affected survival and discover which patients were predicted to benefit from mitral valve repair and which from replacement. Methods A total of 218 consecutive patients underwent either mitral valve repair MVP n 112 or mitral valve replacement MVR n 106 . We retrospectively reviewed the clinical material operation methods echocardiography check during operation and follow-up. Patients details and follow-up outcomes were compared using multivariate and Kaplan-Meier analyses. Results No statistical difference was found between the two groups in term of intraoperative data. Early mortality was MVP and MVR . At discharge Left ventricular end-systolic and end-diastolic diameter and left ventricular ejection fraction LVEF were improved more in the MVP group than MVR group P however in follow-up no statistically significant difference was observed between the MVR and MVP group P . Followup mitral regurgitation grade was significantly improved in the MVR group compared with the MVP group P . The Kaplan-Meier survival estimates at 1 3 and 5 years were simlar between MVP and MVR group. Logistic regression revealed poor survival was associated with old age 75 preoperative renal insufficiency and low left ventricular ejection fraction 30 . Conclusion Mitral valve repair is the procedure of choice in the majority of .