Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective

Messika–Zeitoun, David; Candolfi, Pascal; Enríquez-Sarano, Maurice; Burwash, Ian G.; Chan, Vincent; Philippon, Jean François; Toussaint, Jean Manuel; Verta, Partrick; Feldman, Ted; Iung, Bernard; Glineur, David; Obadia, Jean François; Vahanian, Alec; Mesana, Thierry G.

doi:10.1136/openhrt-2020-001339

Cited by 28 publications

(35 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The French national database reported that the in-hospital mortality rates of patients with isolated valve surgery for SMR were 2.2% after MVP and 7.1% after MVR. 14) Importantly, transcatheter intervention was performed at the same rate as MVP according to the Euro Heart Survey II (32.2%). 8) A report from The Society of Thoracic Surgeons Adult Cardiac Surgery Database from 2011 to 2016 indicated that only 4.2% and 1.3% of mitral valve surgeries were for SMR and IMR, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…According to the French national database between 2014 and 2016 and the Euro Heart Survey II, SMR was observed in 16.2% and 24.3% of patients who underwent mitral valve surgeries, with in-hospital mortality rates of 7.8% and 4.9%, respectively. 8 , 14) Recently, surgeons are more reluctant to perform MVP for 38.9% and 36.8% of patients with SMR, respectively. The French national database reported that the in-hospital mortality rates of patients with isolated valve surgery for SMR were 2.2% after MVP and 7.1% after MVR.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Nationwide Survey of Surgical Treatment for Severe Ischemic Mitral Regurgitation

Masuzawa

Tomomitsu

Arai

et al. 2022

ATCS

View full text Add to dashboard Cite

Objective: Mitral subvalvular procedures in addition to restrictive annuloplasty are promising for ischemic mitral regurgitation (IMR). However, the prevalence and efficacy of specific subvalvular repair in severe IMR have not been elucidated. This is the first nationwide survey regarding surgeons' attitudes toward IMR in Japan. Methods: A questionnaire was sent to 543 institutions. From 2015 to 2019, numbers of elective first-time mitral valve replacement (MVR) with/without complete chordal preservation (CCP)/papillary muscle approximation (PMA) and mitral valvuloplasty (MVP) with/without papillary muscle relocation (PMR)/PMA in patients with severe IMR were collected. Concomitant procedures for coronary artery, tricuspid valve, and arrhythmia could be included but left ventricular reconstruction was excluded. Results: Completed questionnaires were received from 286 institutions (52.7%). The majority (90%) had less than 20 cases within 5 years. The number of MVP (1413, 61.5%) surpassed MVR (886, 38.5%). CCP was performed in half of MVR (50.0%), while PMA was included in only 1.9% of MVR. PMA and PMR were also performed infrequently, in only 7.7% and 10.9% of MVP, respectively. Conclusion: Japanese surgeons aggressively perform MVP for severe IMR. Subvalvular repair was also aggressively performed in addition to MVR, but not to MVP. A multicenter registry study is in progress.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Nationwide Survey of Surgical Treatment for Severe Ischemic Mitral Regurgitation

Masuzawa

Tomomitsu

Arai

et al. 2022

ATCS

View full text Add to dashboard Cite

show abstract

“…Notably, all patients with rheumatic valvular disease underwent replacement in this study 20 . The vast majority of the rheumatic patients included in our manuscript underwent mitral valve replacement—this has been identified as an independent risk factor for increased LOS (vs. mitral valve repair) 21,22 . It is notable that despite this increased LOS, there was no difference in hospital cost between groups.…”

Section: Commentmentioning

confidence: 92%

“…20 The vast majority of the rheumatic patients included in our manuscript underwent mitral valve replacement-this has been identified as an independent risk factor for increased LOS (vs. mitral valve repair). 21,22 It is notable that despite this increased LOS, there was no difference in hospital cost between groups. We have previously identified complications as drivers of hospital cost, and the additional non-ICU care for rheumatic patients should be accounted for in term of expected resources but may not have a meaningful impact of hospital cost.…”

Section: Commentmentioning

confidence: 97%

Contemporary prevalence and outcomes of rheumatic mitral valve surgery

Hawkins

Strobel

Mehaffey

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Objective: Rheumatic mitral valve disease is often viewed as a historic disease in North America with limited contemporary data. We hypothesized that rheumatic pathology remains common and has worse short-term outcomes and higher resource utilization compared to other mitral valve pathologies.Method: All patients undergoing mitral valve repair or replacement (2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019) were extracted from a regional Society of Thoracic Surgeons database. Resource utilization metrics included inflation-adjusted hospital costs. Patients were stratified by mitral valve pathology for univariate analysis.Result: Out of the 6625 mitral valve procedures, 835 (12.6%) were from rheumatic disease, a proportion that incrementally increased over time (+0.39% per year, p = .032). Among 19 hospitals, there was high variability in number of rheumatic mitral operations (median: 22, interquartile range [IQR]: 5-80) and rate of rheumatic repairs (median: 3%, IQR: 0%-6%). Rheumatic patients were younger (62 vs. 65, p < .0001), more often female (75% vs. 43%, p < .001) and with greater burden of heart failure, multi-valve disease, and lung disease, but less coronary disease. There were no differences in operative mortality (5.2% vs. 5.0%, p = .85) or major morbidity (22.2% vs. 21.8%, p = .83). However, resource utilization was higher for rheumatic patients, including more frequent transfusions (43% vs. 39%, p = .012), longer ICU (73 vs. 64 h, p < .0001) and postoperative length of stay (8 vs. 7 days, p < .0001).Conclusions: Rheumatic mitral disease accounts for a meaningful (12%) and rising percentage of mitral valve operations in the region, with high variability among hospitals. Rheumatic mitral surgery yielded similar short-term outcomes compared to nonrheumatic pathology, but required greater resource utilization.

show abstract

Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left‐sided valvular heart disease in Europe. Insights from the ESC‐EORP Valvular Heart Disease II survey

Dreyfus,

Komar,

Attias

et al. 2024

European J of Heart Fail

Self Cite

View full text Add to dashboard Cite

AimsTricuspid regurgitation (TR) is commonly observed in patients with severe left‐sided valvular heart disease (VHD). This study sought to assess TR frequency, management and outcome in this population.Methods and resultsAmong 6883 patients with severe native left‐sided VHD or previous left‐sided valvular intervention enrolled in the EURObservational Research Programme prospective VHD II survey, moderate or severe TR was very frequent in patients with severe mitral VHD (30% when mitral stenosis, 36% when mitral regurgitation [MR]), especially in patients with secondary MR (46%), and rare in patients with severe aortic VHD (4% when aortic stenosis, 3% when aortic regurgitation). An increase in TR grade was associated with a more severe clinical presentation and a poorer 6‐month survival (p < 0.0001). Rates of concomitant tricuspid valve (TV) intervention at the time of left‐sided heart valve surgery were high at the time of mitral valve surgery (50% when mitral stenosis, 41% when MR). Concordance between class I indications (patients with severe TR) for concomitant TV surgery at the time of left‐sided valvular heart surgery according to guidelines and real‐practice decision‐making was very good (88% overall, 95% in patients operated on for MR).ConclusionIn this large international prospective survey among patients with severe left‐sided VHD, moderate/severe TR was frequent in patients with mitral valve disease and was associated with a poorer outcome as TR grade increased. In patients with severe TR, compliance to guidelines for class I indications for concomitant TV surgery at the time of left‐sided heart valve surgery was very good.

show abstract

Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective

Cited by 28 publications

References 42 publications

A Nationwide Survey of Surgical Treatment for Severe Ischemic Mitral Regurgitation

A Nationwide Survey of Surgical Treatment for Severe Ischemic Mitral Regurgitation

Contemporary prevalence and outcomes of rheumatic mitral valve surgery

Tricuspid regurgitation: Frequency, clinical presentation, management and outcome among patients with severe left‐sided valvular heart disease in Europe. Insights from the ESC‐EORP Valvular Heart Disease II survey

Contact Info

Product

Resources

About