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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

21
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
46
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

36
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
36
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

35
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

30
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Updated: Sep 11, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Long-Term Survival After Mitral Valve Replacement by Preoperative Risk: Implications for Patient Selection.

Matthew Kazaleh1, Catherine Wagner1, J'undra Pegues1

  • 1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.

The Annals of Thoracic Surgery
|August 16, 2025
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Summary

The Society of Thoracic Surgeons (STS) Predictive Risk Of Mortality (PROM) score accurately predicts 5-year survival after mitral valve replacement (MVR). This tool aids in better patient selection for MVR surgery.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Statistics

Background:

  • Mitral valve replacement (MVR) carries significant operative risks.
  • The Society of Thoracic Surgeons (STS) Predictive Risk Of Mortality (PROM) calculator is commonly used to quantify these risks.
  • The predictive accuracy of the STS PROM for long-term outcomes after isolated MVR requires further investigation.

Purpose of the Study:

  • To evaluate the 5-year predictive performance of the STS PROM in patients undergoing isolated MVR.
  • To assess the correlation between STS PROM-stratified risk groups and actual long-term mortality.
  • To identify patient characteristics associated with worse long-term survival after MVR.

Main Methods:

  • A cohort of 855 patients undergoing isolated MVR at a high-volume center was analyzed.
  • Patients were stratified into low (<3%), intermediate (3-6%), and high/extreme (>6%) risk groups based on STS PROM.
  • Kaplan-Meier survival analysis and Cox regression modeling were employed to assess mortality and identify predictors of long-term survival.

Main Results:

  • Five-year survival rates were 90.8% (low-risk), 75.5% (intermediate-risk), and 56.4% (high/extreme-risk), demonstrating significant differences among groups (p<0.001).
  • Thirty-day mortality was lower than predicted in both low and high/extreme-risk groups.
  • Preoperative dialysis, hypertension, and urgent operative status were identified as predictors of worse long-term survival.

Conclusions:

  • The STS PROM demonstrates a correlation with 5-year mortality following isolated MVR, even at high-volume centers.
  • While predictive models may overestimate risk in certain settings, the STS PROM remains a valuable tool for risk stratification.
  • Findings support refined risk stratification criteria to optimize patient selection for MVR.