Mitral Valve Surgery for Rheumatic Lesions in Young Patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2555 |
Resumo: | BACKGROUND: The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center. METHODS: Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014. RESULTS: We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention. CONCLUSIONS: Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation. |
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Mitral Valve Surgery for Rheumatic Lesions in Young PatientsHSM CAR PEDHSM CCTHSM ANSAdolescentChildChild, PreschoolFollow-Up StudiesHeart Valve Prosthesis Implantation/methodsMitral Valve/surgeryMitral Valve Insufficiency/surgeryMitral Valve Stenosis/surgeryReoperationRetrospective StudiesRheumatic Heart Disease/surgeryTreatment OutcomeBACKGROUND: The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center. METHODS: Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014. RESULTS: We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention. CONCLUSIONS: Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation.SAGE PublicationsRepositório do Centro Hospitalar Universitário de Lisboa Central, EPECardoso, BLoureiro, PGomes, IGordo, ABanazol, NFragata, ITrigo, CPinto, MFFragata, J2016-08-12T12:08:42Z2016-052016-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2555engWorld J Pediatr Congenit Heart Surg. 2016 May;7(3):321-810.1177/2150135116637806info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:38:19Zoai:repositorio.chlc.min-saude.pt:10400.17/2555Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:19:54.238126Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
title |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
spellingShingle |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients Cardoso, B HSM CAR PED HSM CCT HSM ANS Adolescent Child Child, Preschool Follow-Up Studies Heart Valve Prosthesis Implantation/methods Mitral Valve/surgery Mitral Valve Insufficiency/surgery Mitral Valve Stenosis/surgery Reoperation Retrospective Studies Rheumatic Heart Disease/surgery Treatment Outcome |
title_short |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
title_full |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
title_fullStr |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
title_full_unstemmed |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
title_sort |
Mitral Valve Surgery for Rheumatic Lesions in Young Patients |
author |
Cardoso, B |
author_facet |
Cardoso, B Loureiro, P Gomes, I Gordo, A Banazol, N Fragata, I Trigo, C Pinto, MF Fragata, J |
author_role |
author |
author2 |
Loureiro, P Gomes, I Gordo, A Banazol, N Fragata, I Trigo, C Pinto, MF Fragata, J |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Cardoso, B Loureiro, P Gomes, I Gordo, A Banazol, N Fragata, I Trigo, C Pinto, MF Fragata, J |
dc.subject.por.fl_str_mv |
HSM CAR PED HSM CCT HSM ANS Adolescent Child Child, Preschool Follow-Up Studies Heart Valve Prosthesis Implantation/methods Mitral Valve/surgery Mitral Valve Insufficiency/surgery Mitral Valve Stenosis/surgery Reoperation Retrospective Studies Rheumatic Heart Disease/surgery Treatment Outcome |
topic |
HSM CAR PED HSM CCT HSM ANS Adolescent Child Child, Preschool Follow-Up Studies Heart Valve Prosthesis Implantation/methods Mitral Valve/surgery Mitral Valve Insufficiency/surgery Mitral Valve Stenosis/surgery Reoperation Retrospective Studies Rheumatic Heart Disease/surgery Treatment Outcome |
description |
BACKGROUND: The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center. METHODS: Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014. RESULTS: We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention. CONCLUSIONS: Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-08-12T12:08:42Z 2016-05 2016-05-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2555 |
url |
http://hdl.handle.net/10400.17/2555 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
World J Pediatr Congenit Heart Surg. 2016 May;7(3):321-8 10.1177/2150135116637806 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
SAGE Publications |
publisher.none.fl_str_mv |
SAGE Publications |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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