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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Concomitant mitral valve surgery with aortic valve replacement: a 21-year experience with a single mechanical
Niall C McGonigle1, J Mark Jones, Pushpinder Sidhu
1Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast, UK. niallmcgonigle@hotmail.com
Journal of Cardiothoracic Surgery
|May 26, 2007
Summary
Long-term survival after combined aortic and mitral valve surgery depends on the mitral valve prosthesis, not repair. Outcomes were similar for double valve replacement versus aortic valve replacement with mitral valve repair.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Disease
- Prosthetic Valve Outcomes
Background:
- Previous studies suggest mitral valve prosthesis determines long-term survival in combined aortic and mitral valve replacement.
- This study evaluates the long-term outcomes and durability of aortic valve replacement (AVR) combined with either mitral valve replacement (MVR) or mitral valve repair (MVrep).
Purpose of the Study:
- To assess and compare the long-term outcomes and durability of AVR with MVR versus AVR with MVrep.
- To identify predictors of mortality in patients undergoing combined valve surgery.
Main Methods:
- A 21-year retrospective study of 316 patients (1977-1997) undergoing double valve replacement (DVR) or AVR+MVrep.
- 100% follow-up achieved via questionnaires and medical records review.
- Kaplan-Meier survival analysis and Cox regression modeling were used.
Main Results:
- Fifteen-year survival was 44% for DVR and 57% for AVR+MVrep.
- No significant differences in valve-related deaths, anticoagulation complications, or prosthetic valve endocarditis.
- Mortality predictors like sex or prior cardiac surgery did not significantly impact outcomes.
Conclusions:
- The mitral valve component is the primary determinant of survival after combined aortic and mitral valve surgery.
- Mitral valve repair does not significantly influence survival compared to mitral valve replacement in this context.
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