Type of Valvular Heart Disease Requiring Surgery in the 21st Century: Mortality and Length-of-Stay Related to Surgery

Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac proce-dures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.

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Valvular Heart Disease - Part II

10.2310/fm.1712 ◽

2021 ◽

Author(s):

Miriam S. Jacob ◽

Brian P Griffin

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Aortic Regurgitation ◽

Valvular Heart Disease ◽

Mitral Valve Prolapse ◽

Developed Countries ◽

Cardiac Morbidity ◽

Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications. This review contains 5 figures, 9 tables, and 53 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

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Valvular heart disease

10.1093/med/9780199643219.003.0003 ◽

2012 ◽

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Rheumatic Fever ◽

Aortic Regurgitation ◽

Valvular Heart Disease ◽

Mitral Valve Prolapse ◽

Mitral Stenosis ◽

Acute Rheumatic Fever

General considerations 144Acute rheumatic fever 146Mitral stenosis: clinical features 150Mitral stenosis: investigations 152Mitral stenosis guidelines 156Mitral regurgitation 158Mitral regurgitation guidelines 161Mitral valve prolapse 162Aortic stenosis 164Management of aortic stenosis 168Aortic regurgitation 170Aortic regurgitation guidelines ...

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Mitral valve surgery and maternal and fetal outcome in valvular heart disease

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(02)00416-2 ◽

2003 ◽

Vol 81 (2) ◽

pp. 151-156 ◽

Cited By ~ 9

Author(s):

M. Malhotra ◽

J.B. Sharma ◽

P. Arora ◽

S. Batra ◽

S. Sharma ◽

...

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Valvular Heart Disease ◽

Fetal Outcome ◽

Mitral Valve Surgery ◽

Valve Surgery

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Outcomes of Minimally Invasive Mitral Valve Surgery in Patients with an Ejection Fraction of 35% or Less

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31828da226 ◽

2013 ◽

Vol 8 (1) ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Orlando Santana ◽

Javier Reyna ◽

Andres M. Pineda ◽

Christos G. Mihos ◽

Lior U. Elkayam ◽

...

Keyword(s):

Mitral Valve ◽

Length Of Stay ◽

Mitral Regurgitation ◽

Ejection Fraction ◽

Minimally Invasive ◽

Mitral Valve Surgery ◽

Left Ventricular ◽

Valve Surgery ◽

Severe Mitral Regurgitation ◽

The Mean

Objective We evaluated the outcomes of minimally invasive mitral valve surgery via a right anterior thoracotomy approach in patients with isolated severe mitral regurgitation and severely reduced left ventricular systolic function. Methods We retrospectively reviewed all minimally invasive mitral valve surgeries for mitral regurgitation in patients with an ejection fraction of 35% or less performed at our institution between December 2008 and June 2011. The operative times, lengths of stay, postoperative complications, and mortality were analyzed. Results We identified a total of 71 patients with severe mitral regurgitation and an ejection fraction of 35% or less who underwent minimally invasive mitral valve surgery. The mean ± SD age was 67 ± 10 years, and 44 of the patients were men (62%). The mean ± SD left ventricular ejection fraction was 27% ± 6%, and 28 patients (39%) had previous heart surgery. The median aortic cross-clamp and cardiopulmonary bypass times were 62 [interquartile range (IQR), 50–80) and 98 minutes (IQR, 92–124), respectively. There was no mitral regurgitation noted in any patient on postoperative transesophageal echocardiogram. The median intensive care unit length of stay was 51 hours (IQR, 42–86), and the median postoperative length of stay was 6 days (IQR, 5–9). Conclusions Minimally invasive mitral valve surgery for severe functional mitral regurgitation in patients with severe left ventricular dysfunction can be performed with a low morbidity and mortality.

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Valvular Heart Disease - Part I

10.2310/fm.1226 ◽

2021 ◽

Author(s):

Miriam S. Jacob ◽

Brian P Griffin

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Aortic Regurgitation ◽

Valvular Heart Disease ◽

Mitral Valve Prolapse ◽

Developed Countries ◽

Cardiac Morbidity ◽

Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications. This review contains 6 figures, 13 tables, 69 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

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Correction of moderate secondary mitral regurgitation due to aortic valve disease: immediate results

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2013-4-7-10 ◽

2015 ◽

Vol 17 (2) ◽

pp. 7

Author(s):

V. M. Nazarov ◽

S. I. Zheleznev ◽

I. I. Demin ◽

K. A. Smolyaninov ◽

A. V. Afanasev ◽

...

Keyword(s):

Mitral Valve ◽

Aortic Valve ◽

Mitral Regurgitation ◽

Aortic Insufficiency ◽

Mitral Valve Surgery ◽

Early Postoperative Period ◽

Valve Surgery ◽

Secondary Mitral Regurgitation ◽

Group B ◽

The Impact

To evaluate the impact of surgical strategy in concomitant mitral valve surgery or isolated aortic valve replacement (AVR) in patients with moderate secondary mitral regurgitation (MR), 1 574 patients underwent AVR over a period from January 2003 to December 2011. 241 patients had secondary MR 2+ and constituted the study population. Patients were stratified into two groups, those without concomitant mitral valve surgery (Group A, n = 113) and with it (Group B, n = 128). It was found out that AVR plastic correction of MI reduces its recurrence during short-term follow-up but increases the intervention time leading to an insignificant rise in lethality. In patients with aortic stenosis the age exceeding 70 years and the presence of atrial fibrillation are found to be the most significant predictors of preservation of residual mitral regurgitation in the early postoperative period, while more indicative for patients with aortic insufficiency is the presence of tricuspid regurgitation grade 2 or higher.

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Valvular Heart Disease - Part II

10.2310/im.1712 ◽

2021 ◽

Author(s):

Miriam S. Jacob ◽

Brian P Griffin

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Aortic Regurgitation ◽

Valvular Heart Disease ◽

Mitral Valve Prolapse ◽

Developed Countries ◽

Cardiac Morbidity ◽

Mechanical Prostheses

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Valvular Heart Disease - Part I

10.2310/im.1226 ◽

2021 ◽

Author(s):

Miriam S. Jacob ◽

Brian P Griffin

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Aortic Stenosis ◽

Aortic Regurgitation ◽

Valvular Heart Disease ◽

Mitral Valve Prolapse ◽

Developed Countries ◽

Cardiac Morbidity ◽

Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications. This review contains 6 figures, 13 tables, 69 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

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Faculty Opinions recommendation of Negative impact of atrial fibrillation and pulmonary hypertension after mitral valve surgery in asymptomatic patients with severe mitral regurgitation: a 20-year follow-up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725299911.793503220 ◽

2015 ◽

Author(s):

John Augoustides

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Hypertension ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Negative Impact ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Severe Mitral Regurgitation ◽

Asymptomatic Patients

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Valvular heart disease in autoimmune diseases in Mexico

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.071 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

J Aceituno Melgar ◽

JF Fritche-Salazar ◽

ME Soto-Lopez

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Aortic Valve ◽

Aortic Stenosis ◽

Autoimmune Diseases ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Valvular Heart Disease ◽

Valve Disease ◽

Calcium Deposit

Abstract Funding Acknowledgements Type of funding sources: None. Background The autoimmune diseases (AD) have high morbidity and mortality due to their affection to the heart. Purpose Our objective was to describe the valvular heart disease (VHD) in patients with AD. Methods Patients with systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and systemic sclerosis (SS) diagnosis were included, from January 1st 2008 to December 31th 2018. Prevalence rates of valve involvement were calculated. Results A total of 163 patients (57.6% with SLE, 23.3% with RA, 19.0% with SS) were included. The global prevalence of VHD was 5.4% in SLS, 23.6% en RA, and 15.9% in SS. The more affected valve in SLS was the tricuspid valve in 24% (12% with severe tricuspid regurgitation (STR), p = 0.028), in RA was the aortic valve in 26% (13% with severe aortic stenosis (SAS), p = 0.02), and with SS was the tricuspid valve in 48% (29% with moderate tricuspid regurgitation (MTR)). The calcium deposit was present in 66% in RA (37% in aortic valve, p < 0.001). The valve thickening (>5 mm) was higher in RA (50%, p < 0.001), with predominance in mitral valve (26%). Conclusions We found significant higher rates of STR in SLE, SAS in RA, and MTR in SS compared with the literature. Moreover, calcification and valve thickening were found more often in RA. Early diagnosis of subclinical VHD is mandatory to improve the long-term prognosis of these patients. Valvular heart disease. Autoimmune Disease (n = 163) P value* SLE (n = 94) RA (n = 38) ES (n = 31) Demographic characteristics Age, years. Gender, Male / Female, n Body Mass Index (kg/m2) Arterial hypertension, n (%) Diabetes Mellitus, n (%) 38.8 (12.6) 9/85 26.2 (5.9) 21(22.3%) 6 (6.3%) 62.45 (12.3) 7/31 26.6 (7.1) 14(36.8%) 4 (10.5%) 53.8 (13.3) 2/29 25.4 (4.7) 12 (38.7) 5 (16.1%) <0.001 NS NS NS NS Echocardiographic findings. Valve thickening Aortic Mitral 8 (9%) 1 (1%) 7 (7%) 19 (50%) 9 (24%) 10 (26%) 1 (3%) 0 1 (3%) <0.001 Calcium Deposit Aortic Mitral 4 (4%) 2 (2%) 2 (2%) 25 (66%) 14 (37%) 11 (29%) 8 (26%) 4 (12.8%) 4 (12.9%) <0.001 Aortic valve disease 4 (4%) 10 (26%) 0 Aortic stenosis Moderate Severe 0 0 0 7 (18%) 2 (5%) 5 (13%) 0 0 0 0,02 Moderate Aortic Regurgitation 4 (4%) 3 (8%) 0 NS Mitral valve disease 8 (9%) 2 (5%) 2 (6%) Mitral stenosis Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Mitral Regurgitation Moderate Severe 4 (4%) 2 (2%) 2 (2%) 1 (3%) 0 1 (3%) 1 (3%) 0 1 (3%) NS Tricuspid Regurgitation Moderate Severe 22 (24%) 11 (12%) 11 (12%) 8 (21%) 7 (18%) 1 (3%) 15 (48%) 9 (29%) 6 (19%) 0,028 Pulmonic valve disease Moderate Pulmonic Stenosis Moderate Pulmonic Regurgitation 6 (6%) 1 (1%) 5 (5%) 1 (3%) 0 1 (3%) 0 0 0 NS * Not Significant.

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