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Titolo:
Combined mitral valve and coronary artery surgery: ischemic versus non-ischemic mitral valve disease
Autore:
Seipelt, RG; Schoendube, FA; Vazquez-Jimenez, JF; Doerge, H; Voss, M; Messmer, BJ;
Indirizzi:
Univ Hosp RWTH Aachen, Dept Thorac & Cardiovasc Surg, G-52074 Aachen, Germany Univ Hosp RWTH Aachen Aachen Germany G-52074 rg, G-52074 Aachen, Germany
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 2, volume: 20, anno: 2001,
pagine: 270 - 275
SICI:
1010-7940(200108)20:2<270:CMVACA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
MYOCARDIAL REVASCULARIZATION; REPLACEMENT; REGURGITATION; RECONSTRUCTION; DETERMINANTS; INSUFFICIENCY; SURVIVAL; REPAIR;
Keywords:
mitral valve; ischemic mitral regurgitation; ischemic heart disease; coronary artery bypass surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Seipelt, RG Univ Hosp RWTH Aachen, Dept Thorac & Cardiovasc Surg, Pauwelsstr 30, G-52074 Aachen, Germany Univ Hosp RWTH Aachen Pauwelsstr 30 Aachen Germany G-52074 ny
Citazione:
R.G. Seipelt et al., "Combined mitral valve and coronary artery surgery: ischemic versus non-ischemic mitral valve disease", EUR J CAR-T, 20(2), 2001, pp. 270-275

Abstract

Objectives: Mitral valve combined with coronary artery surgery is associated with a higher hospital mortality than each operation in particular. Controversy exists regarding the predictive value of ischemic mitral valve disease (MVD) on outcome. Methods: Between 1984 and 1997, 262 patients underwent mitral valve operations (replacement, n = 198; repair, n = 64) in combination with coronary revascularization. The etiology of MVD was secondary to ischemic heart disease (group I) in 82 (31%) patients, and non-ischemic (group II) in 180 (69%) patients (rheumatic, 139 patients (53%); degenerative,41 patients (16%)). Both groups were similar in age, cardiac risk factors and pulmonary artery pressure. Patients of group I had significantly more severe coronary artery disease, more often an impaired left ventricle and myocardial infarction, and were in a worse functional condition. The mean number of bypass grafts was significantly higher in group I. The follow-up was98% (230/234 patients). Results: With 19.5%, the hospital mortality was significantly increased in group I compared with 6.7% in group II (P = 0.002;overall, 10.7%). Mitral valve repair or replacement had no influence on early outcome, although mitral valve repair was performed more often in groupI (37 versus 19%). The survival (valve-related event-free survival) after discharge from hospital in the 1st, 5th and loth year was 94 (94%), 70 (66%) and 53% (35%) in group I and 96 (95%), 79 (76%) and 54% (41%) in group II, respectively.. The long-term functional capacity was equally good in bothgroups (New York Heart Association mean, 1.86 versus 1.72). Conclusions: Patients with ischemic MVD are in a worse cardiac condition with significantly higher hospital mortality than patients with non-ischemic MVD and coronary artery bypass grafting. Once discharged from hospital, both groups have comparable long-term outcomes, with the best results in patients with degenerative MVD. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 12:25:36