Long-term Outcomes of Mitral Valve Repair for Atrial Functional Mitral Regurgitation.

IF 3.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery Pub Date : 2024-09-12 DOI:10.1016/j.athoracsur.2024.09.001

Jung-Hoon Shin, Seung-Hyun Lee, Hyun-Chul Joo, Young-Nam Youn, Jung-Hwan Kim, Sak Lee

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引用次数: 0

Abstract

Background: Atrial functional mitral regurgitation (AFMR), defined by normal left ventricular function, enlarged left atrium, and a dilated mitral valve annulus, has been a concept discussed for >10 years. However, there are still no established guidelines for its treatment in the American College of Cardiology/American Heart Association recommendations. This study aimed to determine the long-term outcomes of mitral annuloplasty as a treatment for AFMR.

Methods: We analyzed 1435 patients who underwent mitral valve repair at our institution between 2005 and 2020, with 162 classified as having AFMR. Exclusion criteria for AFMR were established based on preoperative echocardiography and operative notes. The primary outcome was overall mortality, and the secondary outcome was MR recurrence, which was defined as moderate or greater mitral regurgitation observed on echocardiography during the follow-up period, analyzed using our hospital's medical records and data from the National Statistical Office.

Results: The median follow-up duration for the entire patient cohort was 6.1 years (interquartile range, 3.2-11.2 years). Patients had a 5-year survival rate of 86% and a 10-year survival rate of 73%, with freedom from MR recurrence rates of 89% and 80% at 5 and 10 years, respectively. Although all 162 patients had moderate or greater MR before surgery, most experienced trivial or mild MR after mitral valve repair throughout the follow-up period.

Conclusions: In summary, mitral valve repair effectively treats patients with AFMR, addressing survival and mitigating MR recurrence.

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二尖瓣修复术治疗心房功能性二尖瓣反流的长期疗效。

背景：心房功能性二尖瓣反流（AFMR）的定义是左心室功能正常、左心房增大和二尖瓣瓣环扩张，这一概念已被讨论了 10 多年。然而，在 ACC/AHA 的建议中仍没有关于其治疗的既定指南。本研究旨在确定二尖瓣瓣环成形术治疗房颤的长期疗效：2005年至2020年间，我们分析了在本院接受二尖瓣修复术的1435例患者，其中162例被归类为AFMR。根据术前超声心动图和手术记录确定了 AFMR 的排除标准。主要结果是总死亡率，次要结果是二尖瓣返流复发，即随访期间超声心动图观察到的中度或更严重的二尖瓣返流：整个患者队列的中位随访时间为 6.1 年（四分位间范围：3.2-11.2 年）。患者的 5 年生存率为 86%，10 年生存率为 73%，5 年和 10 年后无 MR 复发率分别为 89% 和 80%。虽然所有162名患者在手术前都有中度或更严重的MR，但在二尖瓣修复术后的整个随访期间，大多数患者都出现了轻微或轻度的MR：总之，二尖瓣修复术可有效治疗房颤患者，提高生存率并减少 MR 复发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Thoracic Surgery 医学-呼吸系统

CiteScore

6.40

自引率

13.00%

发文量

1235

审稿时长

42 days

期刊介绍： The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. The Annals of Thoracic Surgery features: • Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques • New Technology articles • Case reports • "How-to-do-it" features • Reviews of current literature • Supplements on symposia • Commentary pieces and correspondence • CME • Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery. An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.