Mitral valve repair versus replacement in simultaneous aortic and mitral valve surgery

Marian Urban, Jan Pirk, Ondrej Szarszoi, Ivo Skalsky, Jiri Maly, Ivan Netuka

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Double valve replacement for concomitant aortic and mitral valve disease is associated with substantial morbidity and mortality. Excellent results with valve repair in isolated mitral valve lesions have been reported; therefore, whether its potential benefits would translate into better outcomes in patients with combined mitral-aortic disease was investigated. METHODS: A retrospective observational study was performed involving 341 patients who underwent aortic valve replacement with either mitral valve repair (n=42) or double valve replacement (n=299). Data were analyzed for early mortality, late valve-related complications and survival. RESULTS: The early mortality rate was 11.9% for valve repair and 11.0% for replacement (P=0.797). Survival (± SD) was 67±11% in mitral valve repair with aortic valve replacement and 81±3% in double valve replacement at five years of follow-up (P=0.187). The percentage of patients who did not experience major adverse valve-related events at five years of follow-up was 83±9% in those who underwent mitral valve repair with aortic valve replacement and 89±2% in patients who underwent double valve replacement (P=0.412). Age >70 years (HR 2.4 [95% CI 1.1 to 4.9]; P=0.023) and renal dysfunction (HR 1.9 [95% CI 1.2 to 3.7]; P=0.01) were independent predictors of decreased survival. CONCLUSIONS: In patients with double valve disease, both mitral valve repair and replacement provided comparable early outcomes. There were no significant differences in valve-related reoperations, anticoagulation-related complications or prosthetic valve endocarditis. Patient-related factors appear to be the major determinant of late survival, irrespective of the type of operation.

Original languageEnglish (US)
Pages (from-to)22-26
Number of pages5
JournalExperimental and Clinical Cardiology
Volume18
Issue number1
StatePublished - Mar 1 2013

Fingerprint

Aortic Valve
Mitral Valve
Survival
Mortality
Aortic Diseases
Endocarditis
Reoperation
Observational Studies
Retrospective Studies
Morbidity
Kidney

Keywords

  • Aortic valve replacement
  • Double valve surgery
  • Mitral valve repair
  • Mitral valve replacement

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Urban, M., Pirk, J., Szarszoi, O., Skalsky, I., Maly, J., & Netuka, I. (2013). Mitral valve repair versus replacement in simultaneous aortic and mitral valve surgery. Experimental and Clinical Cardiology, 18(1), 22-26.

Mitral valve repair versus replacement in simultaneous aortic and mitral valve surgery. / Urban, Marian; Pirk, Jan; Szarszoi, Ondrej; Skalsky, Ivo; Maly, Jiri; Netuka, Ivan.

In: Experimental and Clinical Cardiology, Vol. 18, No. 1, 01.03.2013, p. 22-26.

Research output: Contribution to journalArticle

Urban, M, Pirk, J, Szarszoi, O, Skalsky, I, Maly, J & Netuka, I 2013, 'Mitral valve repair versus replacement in simultaneous aortic and mitral valve surgery', Experimental and Clinical Cardiology, vol. 18, no. 1, pp. 22-26.
Urban, Marian ; Pirk, Jan ; Szarszoi, Ondrej ; Skalsky, Ivo ; Maly, Jiri ; Netuka, Ivan. / Mitral valve repair versus replacement in simultaneous aortic and mitral valve surgery. In: Experimental and Clinical Cardiology. 2013 ; Vol. 18, No. 1. pp. 22-26.
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AB - BACKGROUND: Double valve replacement for concomitant aortic and mitral valve disease is associated with substantial morbidity and mortality. Excellent results with valve repair in isolated mitral valve lesions have been reported; therefore, whether its potential benefits would translate into better outcomes in patients with combined mitral-aortic disease was investigated. METHODS: A retrospective observational study was performed involving 341 patients who underwent aortic valve replacement with either mitral valve repair (n=42) or double valve replacement (n=299). Data were analyzed for early mortality, late valve-related complications and survival. RESULTS: The early mortality rate was 11.9% for valve repair and 11.0% for replacement (P=0.797). Survival (± SD) was 67±11% in mitral valve repair with aortic valve replacement and 81±3% in double valve replacement at five years of follow-up (P=0.187). The percentage of patients who did not experience major adverse valve-related events at five years of follow-up was 83±9% in those who underwent mitral valve repair with aortic valve replacement and 89±2% in patients who underwent double valve replacement (P=0.412). Age >70 years (HR 2.4 [95% CI 1.1 to 4.9]; P=0.023) and renal dysfunction (HR 1.9 [95% CI 1.2 to 3.7]; P=0.01) were independent predictors of decreased survival. CONCLUSIONS: In patients with double valve disease, both mitral valve repair and replacement provided comparable early outcomes. There were no significant differences in valve-related reoperations, anticoagulation-related complications or prosthetic valve endocarditis. Patient-related factors appear to be the major determinant of late survival, irrespective of the type of operation.

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