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Meta-analysis of results of subvalvular repair for severe ischemic mitral regurgitation.
- Source :
-
Journal of cardiac surgery [J Card Surg] 2020 Apr; Vol. 35 (4), pp. 886-896. Date of Electronic Publication: 2020 Mar 11. - Publication Year :
- 2020
-
Abstract
- Background and Aim of the Study: The aim of this meta-analysis was to compare short- and long-term outcomes of patients undergoing mitral annuloplasty (MA) with or without papillary muscle surgery (PMS) for the treatment of ischemic mitral regurgitation (IMR).<br />Methods: A systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were performed.<br />Results: Nine studies met the inclusion criteria. This meta-analysis identified 478 patients: 228 patients underwent MA alone and 250 patients underwent concomitant PMS. Early mortality was similar between two groups (odds ratio [OR] 1.14, 95% confidence interval [CI], 0.51-2.53; P = .75). PMS was associated at follow-up with a higher freedom from cardiac-related events (P = .050); moreover, although both surgical techniques had a positive impact on ventricular remodeling, the PMS group showed a significant higher reduction of left ventricle end-diastolic diameter (OR, 4.89, 95% CI, 2.77-7.01; P < .001) and left ventricle end-systolic diameter values (OR, 4.11, 95% CI, 1.98-6.24; P < .001). Finally, PMS compared with MA alone was associated with a significant reduction of recurrent mitral regurgitation at follow-up (OR, 3.25, 95% CI, 1.60-6.59; P = .001).<br />Conclusions: This meta-analysis demonstrated superiority in terms of ventricular remodeling of a combined approach encompassing PMS and MA over MA alone in IMR. Moreover, the association of subvalvular surgery with restrictive MA decreases the incidence of mitral regurgitation recurrence and cardiac-related events at follow-up.<br /> (© 2020 Wiley Periodicals, Inc.)
- Subjects :
- Diastole
Follow-Up Studies
Heart Ventricles pathology
Heart Ventricles physiopathology
Humans
Mitral Valve Insufficiency pathology
Mitral Valve Insufficiency physiopathology
Papillary Muscles surgery
Secondary Prevention
Severity of Illness Index
Systole
Time Factors
Treatment Outcome
Ventricular Remodeling
Mitral Valve surgery
Mitral Valve Annuloplasty methods
Mitral Valve Insufficiency surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8191
- Volume :
- 35
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cardiac surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32160341
- Full Text :
- https://doi.org/10.1111/jocs.14490