scholarly journals THE USE OF TISSUE PROSTHESIS FOR MITRAL VALVE REPLACEMENT: POSSIBILITY OF DISCONTINUATION OF ANTICOAGULATION

2018 ◽  
Vol 7 (3) ◽  
pp. 72-82 ◽  
Author(s):  
Yu. N. Odarenko ◽  
N. V. Rutkovskaya ◽  
E. V. Gorbunova ◽  
E. A. Khomenko ◽  
S. G. Kokorin ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Mitral Valve ◽  
Sinus Rhythm ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Anticoagulation Therapy ◽  
Maze Procedure ◽  
Efficacy Rate ◽  
Bioprosthetic Mitral Valve

Aim. To evaluate the clinical efficacy of gradual sinus rhythm restoration, including the bioprosthetic mitral valve replacement combined with maze radiofrequency ablation, external cardioversion and catheter ablation.Methods.102 medical records of patients with mitral valve disease and long-standing atrial fibrillation (4,7±2,7 years) were restrospectively reviewed. Maze procedure was performed under extracorporeal circulation before the mitral valve replacement. The endpoints were monitored at the day of surgery, at discharge, and 3, 6 and 12 months after surgery.Results.Sinus rhythm was recorded in 65.7% of patients at discharge from the hospital. The completeness of the follow-up was 80.4%. Steady regular rhythm was maintained in 64.6 % of patients in the study group. Other patients (35.4%) underwent cardioversion with the efficacy rate of 41.4%. Anticoagulation therapy was withdrawn in 65.9% of patients three months after surgery. 18.3% of patients with symptomatic arrhythmia underwent catheter ablation, which allowed to restore sinus rhythm in 73.3% of cases. Sinus rhythm was recorded in 92.7% of cases within the 1-year follow-up. Importantly, 79.3% of patients were discontinued of indirect anticoagulants.Conclusion.Discontinuation of indirect anticoagulants proved its beneficial effects and safety on the restoration of sinus rhythm in patients after bioprosthetic mitral valve replacement.

Continuous Beta-Blocker Therapy Delays Structural Deterioration after Bioprosthetic Mitral Valve Replacement

2019 ◽  
Vol 67 (07) ◽  
pp. 554-556
Author(s):  
Wenrui Ma ◽  
Yan Tan ◽  
Qiuxia Shi ◽  
Zhiwei Xu
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Beta Blocker ◽  
Blocker Therapy ◽  
Structural Deterioration ◽  
Structural Valve Deterioration ◽  
The Impact ◽  
Bioprosthetic Mitral Valve

AbstractThe impact of continuous beta-blocker (BB) therapy on structural valve deterioration (SVD) after bioprosthetic mitral replacement was investigated. From 2000 to 2005, 138 such patients were propensity score matched in a 1:1 fashion (continuous BB therapy after surgery, n = 69; without BB therapy, n = 69). Median follow-up was 12.3 years. Cardiac mortality was comparable between patients with and without BB therapy (p = 0.13), while the 10-year freedom from SVD was significantly higher in patients with BB therapy (92.4 vs. 76.3%, p = 0.001). In conclusion, continuous BB therapy may be considered in patients after bioprosthetic mitral valve replacement to delay SVD and improve prosthetic durability.

scholarly journals Remote Results after Mitral Valve Replacement

2019 ◽  
pp. 36-39
Author(s):  
K. V. Pukas
Keyword(s):  
Mitral Valve ◽  
Sinus Rhythm ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Nyha Class ◽  
Functional Class ◽  
Maze Procedure ◽  
Closed Mitral Commissurotomy ◽  
Valve Diseases

Aim of investigation is to research properties of patients at remote period after mitral valve replacement (MVR). At ana-lyzed group are included 634 patients with mitral valve diseases, which were treated by MVR in National Amosov Institute of cardiovascular diseases from 1st January 2005 to 1st January 2007. Average being of research was 7.3 ± 0.9 years. Following values of research at 10-year step: survival 69.4%, stability of good results – 57.3%, freedom from thromboembolic events – 79.7%, freedom from reoperations – 95.4%. Plasty of LA was performed in 57 (10.1%) patients. Maze procedure was oc-cured in 39 (6.9%) patients. Concomitant tricuspid malformation (TV annuloplasty) was observed in 135 (23.7%) patients. Concomitant CABG was observed in 93 (5.0%) patients. Previous heart surgery (mainly closed mitral commissurotomy) had 129 (21.4%) patients. Reoperations were occured: thromboses (panus, paraprost. fistula) of mitral prostheses (n = 5), endocarditis (n = 3). AV blockade (pacemaker) was occured in 9 (1.6%) patients. Best results of mitral valve replacement were observed in remote period in patients at II–III NYHA class with presence of sinus rhythm. Patients must be followed-up with tightly observation especially risk group–IV functional class, atrial fibrillation, concomitant tricuspid valve diseases, left atriomegaly (diameter of 6.0 cm or more), ejection fraction less than 0.45, high pulmonary hypertension (PASP > 70 mmHg), CABG + progressive ischemic heart disease, left ventriculomegaly (ESVI > 95 ml/mq), female, age more than 60 years. Mitral valve replacement with operation Maze allows successfully renew sinus rhythm on a hospital stage, and stabilize it well during half-year after operation.

Restoration of Sinus Rhythm After Mitral Valve Replacement

Circulation ◽  
1968 ◽  
Vol 37 (4s2) ◽  
Author(s):  
R. DARRYL FISHER ◽  
DEAN T. MASON ◽  
ANDREW G. MORROW
Keyword(s):  
Mitral Valve ◽  
Sinus Rhythm ◽  
Valve Replacement ◽  
Mitral Valve Replacement

What Factors Should Be Considered to Improve Outcome of Mechanical Mitral Valve Replacement in Children?

2021 ◽  
Vol 12 (3) ◽  
pp. 367-374
Author(s):  
Mohamed F. Elsisy ◽  
Joseph A. Dearani ◽  
Elena Ashikhmina ◽  
Prasad Krishnan ◽  
Jason H. Anderson ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Multivariable Analysis ◽  
Permanent Pacemaker ◽  
Early Mortality ◽  
Prosthetic Valve Thrombosis ◽  
Valve Size ◽  
Valve Thrombosis

Objective: To identify risk factors for pediatric mechanical mitral valve replacement (mMVR) to improve management in this challenging population. Methods: From 1993 to 2019, 93 children underwent 119 mMVR operations (median age, 8.8 years [interquartile range [IQR]: 2.1-13.3], 54.6% females) at our institution. Twenty-six (21.8%) patients underwent mMVR at ≤2 years and 93 (78.2%) patients underwent mMVR at >2 years. Median follow-up duration was 7.6 years [IQR: 3.2-12.4]. Results: Early mortality was 9.7%, but decreased with time and was 0% in the most recent era (13.9% from 1993 to 2000, 7.3% from 2001 to 2010, 0% from 2011 to 2019, P = .04). It was higher in patients ≤2 years compared to patients >2 years (26.9% vs 2.2%, P < .01). On multivariable analysis for mitral valve reoperation, valve size <23 mm was significant with a hazard ratio of 5.38 (4.87-19.47, P = .01);. Perioperative stroke occurred in 1% and permanent pacemaker was necessary in 12%. Freedom from mitral valve reoperation was higher in patients >2 years and those with a prosthesis ≥23 mm. Median time to reoperation was 7 years (IQR: 4.5-9.1) in patients >2 years and 3.5 years (IQR: 0.6-7.1) in patients ≤2 years ( P = .0511), but was similar between prosthesis sizes ( P = .6). During follow-up period (median 7.6 years [IQR: 3.2-12.4], stroke occurred in 10%, prosthetic valve thrombosis requiring reoperation in 4%, endocarditis in 3%, and bleeding in 1%. Conclusion: Early and late outcomes of mMVR in children are improved when performed at age >2 years and with prosthesis size ≥23 mm. These factors should be considered in the timing of mMVR.

scholarly journals Mitral valve repair in heart failure: Five-year follow-up from the mitral valve replacement stratum of the Acorn randomized trial

2011 ◽  
Vol 142 (3) ◽  
pp. 569-574.e1 ◽  
Author(s):  
Michael A. Acker ◽  
Mariell Jessup ◽  
Steven F. Bolling ◽  
Jae Oh ◽  
Randall C. Starling ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Randomized Trial ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Valve Repair

Pulmonary Autograft Mitral Valve Replacement (Ross II): Long-Term Follow-Up of a US Center

2018 ◽  
Vol 9 (6) ◽  
pp. 645-650
Author(s):  
David Blitzer ◽  
Jeremy L. Herrmann ◽  
John W. Brown
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Sudden Cardiac Arrest ◽  
Right Heart Failure ◽  
Atrioventricular Canal ◽  
Pulmonary Autograft ◽  
Atrioventricular Canal Defect

Background: Mitral valve replacement (MVR) with a pulmonary autograft (Ross II) may be a useful technique for pediatric and young adult patients who wish to avoid anticoagulation. Our aim was to evaluate the long-term outcomes of the Ross II procedure at our institution. Methods: Patients undergoing the Ross II procedure between June 2002 and April 2008 were included. Preoperative diagnoses included rheumatic disease (n = 5), congenital mitral valve (MV) pathology (partial atrioventricular canal defect [n = 2], complete atrioventricular canal defect [n = 1], Shone's complex [n = 1]), and myocarditis (n = 1). Results: Ten patients (eight females and two males) between 7 months and 46 years were included. Mean age at surgery was 25.2 ± 15.7 years. There were no in-hospital deaths. Mean follow-up was 11.7 ± 5.2 years. There were three late deaths at 11 months, 5 years, and 11 years, respectively. Causes of death included right heart failure, sepsis, and sudden cardiac arrest. Three patients required subsequent mechanical MVR a median of two years after the Ross II procedure (range: 1-4 years). There was no mortality with reoperation. Echocardiographic follow-up demonstrated mean MV gradients ranging from 2.2 to 9.6 mm Hg. Two patients had greater than mild MV regurgitation postoperatively, and all others had minimal mitral regurgitation or less. Two patients developed moderate MV stenosis. Conclusions: The Ross II procedure is an option for select older children and young adults desiring a durable tissue MVR to avoid long-term anticoagulation.

Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation

Heart ◽  
2010 ◽  
Vol 96 (14) ◽  
pp. 1126-1131 ◽  
Author(s):  
J. B. Kim ◽  
M. H. Ju ◽  
S. C. Yun ◽  
S. H. Jung ◽  
C. H. Chung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Maze Procedure
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