A simple preoperative score including the surgeon's experience to predict the probability of a successful mitral valve repair

Stahel, Hendrik T. Tevaearai; Kammermann, Andrea; Gahl, Brigitta; Englberger, Lars; Carrel, Thierry

doi:10.1093/icvts/ivw347

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…From the valvular heart disease point of view, MAC has been associated with both mitral stenosis and regurgitation in observational studies, likely related to a combination of leaflet restriction, chordal traction, annular distortion, incomplete coaptation, and risk of endocarditis 4,43,44 . MAC adds complexity for the intention to surgically repair the mitral valve, and we found its presence to be highly associated with the need to replace the mitral valve in two studies 15,29 . Surgical strategies to deal with severe MAC may sometimes be necessary, such as mitral annular decalcification and reconstruction, periannular deep suture placement, left atrial to ventricular conduit, and intra‐atrial prosthesis placement 2,45 .…”

Section: Discussionmentioning

confidence: 72%

“…Literature search and disposition of studies results are listed in Figure 1. There were 799 records identified from database search after duplicates were removed, and after screening the abstract 122 full‐text articles were evaluated and 26 studies were eventually included in our the quantitative meta‐analysis totaling 35 070 subjects 6‐31 . Characteristics of included studies are shown in Table 1, published between 1992 and 2017.…”

Section: Resultsmentioning

confidence: 99%

“…Certainly in elderly patients with cardiovascular risk factors, the true prevalence of MAC is likely toward the higher end of this range. Patient characteristics therefore need to be considered in applying these findings 6‐31 . All studies were performed in the United States or Europe.…”

Section: Discussionmentioning

confidence: 99%

“…The average age ranged from 47 to 81 years, and males made up 31%‐100%. Inclusion criteria for patients included a mix of nonselective adult (and frequently elderly) outpatients undergoing cardiac imaging, 6,7,10,12,13,17‐22,24,30,31 to those with cardiovascular risk factors, 16,26 established cardiovascular disease, 8,14,23 valvular heart disease, 11,15,27,29 atrial fibrillation, 25 and even renal failure or transplant, 9,28 suggesting the findings can be applied to the general population and a range of conditions.…”

Section: Discussionmentioning

confidence: 99%

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Relationships between mitral annular calcification and cardiovascular events: A meta‐analysis

Wang

Griffin

et al. 2020

Echocardiography

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Background Mitral annular calcification (MAC) is prevalent in the aging population, with recent renewed interest regarding its associations with cardiovascular risk factors, outcomes, and influence on valvular heart disease and interventions. This meta‐analysis aimed to report the relationships between MAC and cardiovascular mortality and morbidity events. Methods Relevant studies were searched from PubMed, Cochrane, and Embase databases until November 30, 2019. Associations between MAC as a binary variable with death and cardiovascular events were pooled using random‐effects models. The main outcomes of interest were all‐cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, atrial fibrillation, and procedural outcomes. Results Among 799 article abstracts and 122 full‐text articles screened, 26 (16 prospective and 10 retrospective) studies totaling 35 070 subjects were analyzed. MAC was associated with higher all‐cause death, hazard ratio (95% confidence interval) 1.76 (1.43‐2.22), and cardiovascular mortality 1.85 (1.45‐23.5). It also positively correlated with myocardial infarction 1.48 (1.22‐1.79), stroke 1.51 (1.22‐2.05), incidental heart failure 1.55 (1.30‐1.84), atrial fibrillation 1.75 (1.43‐2.15), and their composite, major adverse cardiovascular events (MACE). Finally, conversion to mitral valve replacement at time of cardiac surgery was more in patients with MAC than without MAC, with odds ratio (95% confidence interval) 2.82 (1.28‐6.18). Conclusion Mitral annular calcification was overall associated with higher rates of death, and both individual and composite cardiovascular events. The presence of increasingly encountered MAC has significant clinical implications for cardiovascular risk assessment and valvular interventions.

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Section: Discussionmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Relationships between mitral annular calcification and cardiovascular events: A meta‐analysis

Wang

Griffin

et al. 2020

Echocardiography

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Multi-Modality Imaging in the Evaluation and Treatment of Mitral Regurgitation

Bouchard

Côté-Laroche

Beaudoin

2017

Curr Treat Options Cardio Med

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Mitral regurgitation (MR) is frequent and associated with increased mortality and morbidity when severe. It may be caused by intrinsic valvular disease (primary MR) or ventricular deformation (secondary MR). Imaging has a critical role to document the severity, mechanism, and impact of MR on heart function as selected patients with MR may benefit from surgery whereas other will not. In patients planned for a surgical intervention, imaging is also important to select candidates for mitral valve (MV) repair over replacement and to predict surgical success. Although standard transthoracic echocardiography is the first-line modality to evaluate MR, newer imaging modalities like three-dimensional (3D) transesophageal echocardiography, stress echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) are emerging and complementary tools for MR assessment. While some of these modalities can provide insight into MR severity, others will help to determine its mechanism. Understanding the advantages and limitations of each imaging modality is important to appreciate their respective role for MR assessment and help to resolve eventual discrepancies between different diagnostic methods. With the increasing use of transcatheter mitral procedures (repair or replacement) for high-surgical-risk patients, multimodality imaging has now become even more important to determine eligibility, preinterventional planning, and periprocedural guidance.

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Rheumatic mitral valve repair in the developing world: ‘a very different ball game’

Patel

Malhotra

2021

Indian J Thorac Cardiovasc Surg

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A simple preoperative score including the surgeon's experience to predict the probability of a successful mitral valve repair

Abstract: Preoperative assessment of seven variables can accurately predict the risk of an unsuccessful MV repair.

Cited by 5 publications

References 18 publications

Relationships between mitral annular calcification and cardiovascular events: A meta‐analysis

Relationships between mitral annular calcification and cardiovascular events: A meta‐analysis

Multi-Modality Imaging in the Evaluation and Treatment of Mitral Regurgitation

Rheumatic mitral valve repair in the developing world: ‘a very different ball game’

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