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Mitral valve repair is underused in patients with hypertrophic obstructive cardiomyopathy

Christina M Vassileva1, Theresa Boley, Stephen Markwell

  • 1Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9638, USA. cvassileva@siumed.edu

The Heart Surgery Forum
|December 15, 2011
PubMed

Insights

Mitral valve replacement is more common than repair in hypertrophic obstructive cardiomyopathy (HOCM) patients. Repair offers better outcomes with lower mortality and shorter hospital stays, suggesting specialized centers improve HOCM surgical results.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Medical Database Analysis

Background:

  • Optimal surgical strategy for hypertrophic obstructive cardiomyopathy (HOCM) with mitral valve (MV) regurgitation remains debated.
  • Previous studies lack comprehensive data on current treatment patterns for HOCM patients with MV pathology.

Purpose of the Study:

  • To analyze the most frequent surgical approach for mitral valve (MV) pathology in patients diagnosed with hypertrophic obstructive cardiomyopathy (HOCM).
  • To compare outcomes of mitral valve (MV) repair versus replacement in HOCM patients using a large national database.

Main Methods:

  • Utilized the Nationwide Inpatient Sample (NIS) database (2005-2008).
  • Identified HOCM patients undergoing either MV repair or replacement.
  • Compared baseline characteristics, repair rates, hospital mortality, and length of stay (LOS).

Main Results:

  • Mitral valve (MV) repair was performed in 17.2% of hypertrophic obstructive cardiomyopathy (HOCM) cases.
  • Hospital mortality was significantly lower for MV repair (0.00%) compared to replacement (11.18%).
  • Median length of stay (LOS) was shorter for MV repair (7 days) versus replacement (11 days).

Conclusions:

  • The majority of hypertrophic obstructive cardiomyopathy (HOCM) patients undergo mitral valve (MV) replacement.
  • Mitral valve (MV) repair is associated with superior operative outcomes in HOCM patients.
  • Referral to specialized centers may improve surgical outcomes for HOCM patients with MV pathology.
Abstract

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