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Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important?
Objective This study was undertaken to determine hemodynamic and clinical outcomes of annuloplasty with a standard-sized (63 mm) posterior band in adult patients undergoing mitral valve repair for degenerative valve disease. Methods We studied 511 patients who underwent isolated mitral valve repair...
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| Published in: | The Journal of thoracic and cardiovascular surgery 2009-10, Vol.138 (4), p.886-891 |
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| creator | Brown, Morgan L., MD Schaff, Hartzell V., MD Li, Zhuo, MS Suri, Rakesh M., MD Daly, Richard C., MD Orszulak, Thomas A., MD |
| description | Objective This study was undertaken to determine hemodynamic and clinical outcomes of annuloplasty with a standard-sized (63 mm) posterior band in adult patients undergoing mitral valve repair for degenerative valve disease. Methods We studied 511 patients who underwent isolated mitral valve repair for degenerative disease with a 63-mm posterior band used for annuloplasty. Operations were performed between 1994 and 2001, and average follow-up was 4.8 ± 3.1 years. Echocardiographic data were reviewed, with specific focus on the relationship between patient size and residual mitral regurgitation and gradient. Results Mean age at the time of operation was 59.3 ± 13.5 years, and 72% were male. Body mass index was 25.8 ± 4.1 kg/m2 , and body surface area was 1.97 ± 0.24 m2 . Preoperative mean ejection fraction was 64% ± 7%, and 96% of patients had severe mitral regurgitation on preoperative echocardiography. The 30-day mortality was 0.8%. At hospital discharge, the mean gradient was 4.7 ± 3.1 mm Hg. Body surface area, body mass index, and weight were not associated with postoperative gradients or residual regurgitation at discharge. At last follow-up, 89% of patients had no or mild regurgitation, and the mean ejection fraction was 58% ± 9%. At 5 years, survival was 95% and cumulative risk of reoperation was 3%. Conclusion A standard-sized (unmeasured) posterior annuloplasty band provided excellent intermediate results with good durability. There were neither excess gradients in larger patients nor excess regurgitation in smaller patients. Measured annuloplasty is unnecessary for most adults undergoing mitral valve repair. |
| doi_str_mv | 10.1016/j.jtcvs.2009.01.022 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67667032</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522309003444</els_id><sourcerecordid>67667032</sourcerecordid><originalsourceid>FETCH-LOGICAL-c519t-14977d9a21123c5434498738ae88f31df6be0b3c05246b46aff0a2739d149ac13</originalsourceid><addsrcrecordid>eNqFkl2L1TAQhoso7nH1FwiSG_WqdZK0aSuoyOLHwoLgB3gX0jTdk2Pa1Ex6luOvN91zUPDGq8DwvJPhmcmyxxQKClS82BW7qPdYMIC2AFoAY3eyDYW2zkVTfb-bbSCV8ooxfpY9QNwBQA20vZ-d0VYI4JXYZN1ng4uLSPxARhuDcmSv3N4QNU2L87NTGA_kxsYtUQSjmnoV-hztL9OT2WM0wfpAulR_SS6RjEbhEux0Tew4-5D4-OZhdm9QDs2j03uefXv_7uvFx_zq04fLi7dXua5oG3NatnXdt4pRyriuSl6WbVPzRpmmGTjtB9EZ6LiGipWiK4UaBlCs5m2fkkpTfp49O_adg_-5GIxytKiNc2oyfkEpaiFq4CyB_Ajq4BGDGeQc7KjCQVKQq1q5k7dq5apWApXJY0o9ObVfutH0fzMnlwl4egIUauWGoCZt8Q_HWHJf3nLPj9zWXm9vbDASR-VcakvXb5HyRpayaVby1ZE0SdvemiBRWzNp06eUjrL39j8jv_4nr52dbBruhzkY3PklTGkjkkpkEuSX9V7Wc4EWIOkv-W9Ekbs8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67667032</pqid></control><display><type>article</type><title>Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important?</title><source>Elsevier ScienceDirect Journals</source><creator>Brown, Morgan L., MD ; Schaff, Hartzell V., MD ; Li, Zhuo, MS ; Suri, Rakesh M., MD ; Daly, Richard C., MD ; Orszulak, Thomas A., MD</creator><creatorcontrib>Brown, Morgan L., MD ; Schaff, Hartzell V., MD ; Li, Zhuo, MS ; Suri, Rakesh M., MD ; Daly, Richard C., MD ; Orszulak, Thomas A., MD</creatorcontrib><description>Objective This study was undertaken to determine hemodynamic and clinical outcomes of annuloplasty with a standard-sized (63 mm) posterior band in adult patients undergoing mitral valve repair for degenerative valve disease. Methods We studied 511 patients who underwent isolated mitral valve repair for degenerative disease with a 63-mm posterior band used for annuloplasty. Operations were performed between 1994 and 2001, and average follow-up was 4.8 ± 3.1 years. Echocardiographic data were reviewed, with specific focus on the relationship between patient size and residual mitral regurgitation and gradient. Results Mean age at the time of operation was 59.3 ± 13.5 years, and 72% were male. Body mass index was 25.8 ± 4.1 kg/m2 , and body surface area was 1.97 ± 0.24 m2 . Preoperative mean ejection fraction was 64% ± 7%, and 96% of patients had severe mitral regurgitation on preoperative echocardiography. The 30-day mortality was 0.8%. At hospital discharge, the mean gradient was 4.7 ± 3.1 mm Hg. Body surface area, body mass index, and weight were not associated with postoperative gradients or residual regurgitation at discharge. At last follow-up, 89% of patients had no or mild regurgitation, and the mean ejection fraction was 58% ± 9%. At 5 years, survival was 95% and cumulative risk of reoperation was 3%. Conclusion A standard-sized (unmeasured) posterior annuloplasty band provided excellent intermediate results with good durability. There were neither excess gradients in larger patients nor excess regurgitation in smaller patients. Measured annuloplasty is unnecessary for most adults undergoing mitral valve repair.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2009.01.022</identifier><identifier>PMID: 19660356</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral Valve - diagnostic imaging ; Mitral Valve - surgery ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - physiopathology ; Mitral Valve Insufficiency - surgery ; Pneumology ; Stroke Volume ; Ultrasonography</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2009-10, Vol.138 (4), p.886-891</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2009 The American Association for Thoracic Surgery</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c519t-14977d9a21123c5434498738ae88f31df6be0b3c05246b46aff0a2739d149ac13</citedby><cites>FETCH-LOGICAL-c519t-14977d9a21123c5434498738ae88f31df6be0b3c05246b46aff0a2739d149ac13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522309003444$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,786,790,3568,27957,27958,45815</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22019456$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19660356$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brown, Morgan L., MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><creatorcontrib>Li, Zhuo, MS</creatorcontrib><creatorcontrib>Suri, Rakesh M., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Orszulak, Thomas A., MD</creatorcontrib><title>Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important?</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective This study was undertaken to determine hemodynamic and clinical outcomes of annuloplasty with a standard-sized (63 mm) posterior band in adult patients undergoing mitral valve repair for degenerative valve disease. Methods We studied 511 patients who underwent isolated mitral valve repair for degenerative disease with a 63-mm posterior band used for annuloplasty. Operations were performed between 1994 and 2001, and average follow-up was 4.8 ± 3.1 years. Echocardiographic data were reviewed, with specific focus on the relationship between patient size and residual mitral regurgitation and gradient. Results Mean age at the time of operation was 59.3 ± 13.5 years, and 72% were male. Body mass index was 25.8 ± 4.1 kg/m2 , and body surface area was 1.97 ± 0.24 m2 . Preoperative mean ejection fraction was 64% ± 7%, and 96% of patients had severe mitral regurgitation on preoperative echocardiography. The 30-day mortality was 0.8%. At hospital discharge, the mean gradient was 4.7 ± 3.1 mm Hg. Body surface area, body mass index, and weight were not associated with postoperative gradients or residual regurgitation at discharge. At last follow-up, 89% of patients had no or mild regurgitation, and the mean ejection fraction was 58% ± 9%. At 5 years, survival was 95% and cumulative risk of reoperation was 3%. Conclusion A standard-sized (unmeasured) posterior annuloplasty band provided excellent intermediate results with good durability. There were neither excess gradients in larger patients nor excess regurgitation in smaller patients. Measured annuloplasty is unnecessary for most adults undergoing mitral valve repair.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Female</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - surgery</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - physiopathology</subject><subject>Mitral Valve Insufficiency - surgery</subject><subject>Pneumology</subject><subject>Stroke Volume</subject><subject>Ultrasonography</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNqFkl2L1TAQhoso7nH1FwiSG_WqdZK0aSuoyOLHwoLgB3gX0jTdk2Pa1Ex6luOvN91zUPDGq8DwvJPhmcmyxxQKClS82BW7qPdYMIC2AFoAY3eyDYW2zkVTfb-bbSCV8ooxfpY9QNwBQA20vZ-d0VYI4JXYZN1ng4uLSPxARhuDcmSv3N4QNU2L87NTGA_kxsYtUQSjmnoV-hztL9OT2WM0wfpAulR_SS6RjEbhEux0Tew4-5D4-OZhdm9QDs2j03uefXv_7uvFx_zq04fLi7dXua5oG3NatnXdt4pRyriuSl6WbVPzRpmmGTjtB9EZ6LiGipWiK4UaBlCs5m2fkkpTfp49O_adg_-5GIxytKiNc2oyfkEpaiFq4CyB_Ajq4BGDGeQc7KjCQVKQq1q5k7dq5apWApXJY0o9ObVfutH0fzMnlwl4egIUauWGoCZt8Q_HWHJf3nLPj9zWXm9vbDASR-VcakvXb5HyRpayaVby1ZE0SdvemiBRWzNp06eUjrL39j8jv_4nr52dbBruhzkY3PklTGkjkkpkEuSX9V7Wc4EWIOkv-W9Ekbs8</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Brown, Morgan L., MD</creator><creator>Schaff, Hartzell V., MD</creator><creator>Li, Zhuo, MS</creator><creator>Suri, Rakesh M., MD</creator><creator>Daly, Richard C., MD</creator><creator>Orszulak, Thomas A., MD</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20091001</creationdate><title>Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important?</title><author>Brown, Morgan L., MD ; Schaff, Hartzell V., MD ; Li, Zhuo, MS ; Suri, Rakesh M., MD ; Daly, Richard C., MD ; Orszulak, Thomas A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c519t-14977d9a21123c5434498738ae88f31df6be0b3c05246b46aff0a2739d149ac13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Female</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - surgery</topic><topic>Mitral Valve Insufficiency - diagnostic imaging</topic><topic>Mitral Valve Insufficiency - physiopathology</topic><topic>Mitral Valve Insufficiency - surgery</topic><topic>Pneumology</topic><topic>Stroke Volume</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brown, Morgan L., MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><creatorcontrib>Li, Zhuo, MS</creatorcontrib><creatorcontrib>Suri, Rakesh M., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Orszulak, Thomas A., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brown, Morgan L., MD</au><au>Schaff, Hartzell V., MD</au><au>Li, Zhuo, MS</au><au>Suri, Rakesh M., MD</au><au>Daly, Richard C., MD</au><au>Orszulak, Thomas A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important?</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>138</volume><issue>4</issue><spage>886</spage><epage>891</epage><pages>886-891</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Objective This study was undertaken to determine hemodynamic and clinical outcomes of annuloplasty with a standard-sized (63 mm) posterior band in adult patients undergoing mitral valve repair for degenerative valve disease. Methods We studied 511 patients who underwent isolated mitral valve repair for degenerative disease with a 63-mm posterior band used for annuloplasty. Operations were performed between 1994 and 2001, and average follow-up was 4.8 ± 3.1 years. Echocardiographic data were reviewed, with specific focus on the relationship between patient size and residual mitral regurgitation and gradient. Results Mean age at the time of operation was 59.3 ± 13.5 years, and 72% were male. Body mass index was 25.8 ± 4.1 kg/m2 , and body surface area was 1.97 ± 0.24 m2 . Preoperative mean ejection fraction was 64% ± 7%, and 96% of patients had severe mitral regurgitation on preoperative echocardiography. The 30-day mortality was 0.8%. At hospital discharge, the mean gradient was 4.7 ± 3.1 mm Hg. Body surface area, body mass index, and weight were not associated with postoperative gradients or residual regurgitation at discharge. At last follow-up, 89% of patients had no or mild regurgitation, and the mean ejection fraction was 58% ± 9%. At 5 years, survival was 95% and cumulative risk of reoperation was 3%. Conclusion A standard-sized (unmeasured) posterior annuloplasty band provided excellent intermediate results with good durability. There were neither excess gradients in larger patients nor excess regurgitation in smaller patients. Measured annuloplasty is unnecessary for most adults undergoing mitral valve repair.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19660356</pmid><doi>10.1016/j.jtcvs.2009.01.022</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiology. Vascular system Cardiothoracic Surgery Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation Humans Male Medical sciences Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - surgery Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - physiopathology Mitral Valve Insufficiency - surgery Pneumology Stroke Volume Ultrasonography |
| title | Results of mitral valve annuloplasty with a standard-sized posterior band: Is measuring important? |
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