scholarly journals Outcome of Unilateral Pulmonary Edema after Minimal-Invasive Mitral Valve Surgery: 10-Year Follow-Up

2021 ◽  
Vol 10 (11) ◽  
pp. 2411
Author(s):  
Thomas Puehler ◽  
Christine Friedrich ◽  
Georg Lutter ◽  
Maike Kornhuber ◽  
Mohamed Salem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Reference Number ◽  
Unilateral Pulmonary Edema

The study was approved by the institutional review board (IRB) at the University Medical Center Campus Kiel, Kiel, Germany (reference number: AZ D 559/18) and registered at the German Clinical Trials Register (reference number: DRKS00022222). Objective. Unilateral pulmonary edema (UPE) is a complication after minimally invasive mitral valve surgery (MIMVS). We analyzed the impact of this complication on the short- and long-term outcome over a 10-year period. Methods. We retrospectively observed 393 MIMVS patients between 01/2009 and 12/2019. The primary endpoint was a radiographically and clinically defined UPE within the first postoperative 24 h, secondary endpoints were 30-day and long-term mortality and the percentage of patients requiring ECLS. Risk factors for UPE incidence were evaluated by logistic regression, and risk factors for mortality in the follow-up period were assessed by Cox regression. Results. Median EuroSCORE II reached 0.98% in the complete MIMVS group. Combined 30-day and in-hospital mortality after MIMVS was 2.0% with a 95, 93 and 77% survival rate after 1, 3 and 10 years. Seventy-two (18.3%) of 393 patients developed a UPE 24 h after surgery. Six patients (8.3%) with UPE required an extracorporeal life-support system. Logistic regression analysis identified a higher creatinine level, a worse LV function, pulmonary hypertension, intraoperative transfusion and a longer aortic clamp time as predictors for UPE. Combined in hospital mortality and 30-day mortality was slightly but not significantly higher in the UPE group (4.2 vs. 1.6%; p = 0.17). Predictors for mortality during follow-up were age ≥ 70 years, impaired RVF, COPD, drainage loss ≥ 800 mL and length of ventilation ≥ 48 h. During a median follow-up of 4.6 years, comparable survival between UPE and non-UPE patients was seen in our analysis after 5 years (89 vs. 88%; p = 0.98). Conclusions. In-hospital outcome with UPE after MIMVS was not significantly worse compared to non-UPE patients, and no differences were observed in the long-term follow-up. However, prolonged aortic clamp time, worse renal and left ventricular function, pulmonary hypertension and transfusion are associated with UPE.

scholarly journals Percutaneous mitral balloon valvuloplasty. Single versus Inoue balloon. long term follow-up

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Aragao ◽  
E.C.S Peixoto ◽  
R.T.S Peixoto ◽  
R.T.S Peixoto ◽  
I.L.P.B Dos Anjos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Balloon Valvuloplasty ◽  
Long Term Follow Up ◽  
Independent Risk Factors ◽  
Inoue Balloon

Abstract Introduction The single balloon (SB) is the less expensive technique to perform mitral balloon valvuloplasty (MBV). Objectives: This study aimed to demonstrate that MBV with the Balt single (BSB) and Inoue ballon, the wordwire accepted technique, had similar outcome and long-term follow-up (FU). Methods From 1987 to 2013, 526 procedures were performed, being 312 with a FU, 56 (17,9%) with Inoue balloon (IB) and 256 (82,1%) with BSB. The mean FU 156±144 months, p<0.0001. Univariate analysis (UA) and multivariate Cox analysis (MCA) to determine independent predict variables of survival and event free survival (EFS) of death, cardiac surgery and new MBV, in both techniques groups. Results In IB and BSB groups there were, respectively: female 42 (75.0%) and 222 (86.7%); mean age 37.3±10.0 (19 to 63) and 38.0±12.6 (13 to 83) years, p=0.7138; sinus rhythm 51 (91.1%) and 215 (84.0%), p=0.1754; echo score (ES) 7.6±1.3 (5 to 10) and 7.2±1.5 (4 to 14) points, p=0.0528; echo mitral valve area (MVA) pre-MBV 0.96±0.18 and 0.93±0.21 cm2, p=0.2265; post-MBV mean MVA (Gorlin) were 2.00±0.52 and 2.02±0.37 cm2, p=0.9554; MBV dilatation área 6,09±0,27 and 7,02±0,30, p<0,0001. At the end of the FU, there were in IB and BSB groups, respectively: echo MVA 1.71±0.41 and 1.54±0.51 cm2, p=0.0552; new severe mitral regurgitation in 5 (8.9%) and 17 (6.6%) patients, p=0.5633; new MBV in 1 (1.8%) and 13 (5.1%), p=0.4779; mitral valve surgery in 3 (5.4%) and 27 (10.4%), p=0.3456; deaths 2 (3.6%) and 11 (4.3%), p=1.000; cardiac deaths 1 (1.8%) and 9 (3.5%), p=1.000; ME 5 (8.9%) and 46 (18.0%), p=0.1449. In UA and MCA the BSB or IB technique do not predict survival or EFS. The independent risk factors to survival were: age <50 years (p=0.016, HR=0.233, 95% IC 0.071- 0.764), ES ≤8 (p<0.001, HR=0.105, 95% IC 0.34–0.327), MBV dilatation area (p<0.001, HR 16.838, 95% IC 3.353–84.580) and no mitral valve surgery in the FU (p=0.001, HR0.152, 95% IC 0.050–0.459). Independent risk factors to EFS: no prior commissurotomy (p=0.012, HR=0.390, 95% IC 0.187–0.813) and post-MBV MVA ≥1.50 cm2 (p=0.001, HR=7.969, 95% IC 3.413–18.608). Conclusion In 25 years, survival and EFS were similar in BSB and IB technique. Independent predictors of surviva: age <50 years, ES≤8 points, MBV dilatation area >7 mm2 and no mitral valve surgery in the FU. Independent predictors of EFS: no prior commissurotomy and post-MBV MVA≥1.50 cm2 Funding Acknowledgement Type of funding source: None

Long term follow-up in quality of life after mitral valve surgery

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
I Kammerer ◽  
M Höhn ◽  
AH Kiessling ◽  
S Becker ◽  
FU Sack
Keyword(s):  
Quality Of Life ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Follow Up

Long-term results of mitral valve surgery in patients with severe pulmonary hypertension

1996 ◽  
Vol 61 (5) ◽  
pp. 1583-1584 ◽  
Author(s):  
Maria Luisa Cámara ◽  
Alejandro Aris ◽  
José M. Padró ◽  
José M. Caralps
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Results ◽  
Severe Pulmonary Hypertension

Long-term Results of Mitral Valve Surgery in Patients with Severe Pulmonary Hypertension

1988 ◽  
Vol 45 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Maria Luisa Cámara ◽  
Alejandro Aris ◽  
José M. Padró ◽  
José M. Caralps
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Results ◽  
Severe Pulmonary Hypertension

scholarly journals Preoperative and predischarge predictors for persistent pulmonary hypertension after mitral valve surgery in patients with chronic organic mitral regurgitation

2015 ◽  
pp. 70-9
Author(s):  
Rina Ariani ◽  
Indriwanto Sakidjan ◽  
Budhi Setianto
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Hypertension ◽  
Multivariate Analysis ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Persistent Pulmonary Hypertension ◽  
Post Operative Atrial Fibrillation

Objectives. This study sought to evaluate the prevalence of pulmonary hypertension after mitral valve surgery ini patients with chronic organic mitral regurgitation and to determine preoperative and predischarge predictors for persistent pulmonary hypertension after surgeryMethods. This is a cohort retrospective study involving subjects with chronic organic mitral regurgitation with preoperative systolic PA pressure > 50 mmHg undergoing surgery. Demographic and echocardiography datas were collected prior to surgery, predischarge, and follow up datas were evaluated after minimal 6 months duration. Subjects were then devided into groups based on existence of persistent pulmonary hypertension after follow up. Bivariate and multivariate analysis was done to determine contributing factors.Results.There were 92 subjects with dominant mitral regurgitation included in this study with median age 40 (range 17-68) years with slight female predominance (55%). Persistent pulmonary hypertension was observed in 23 subjects (25%) predischarge and in 20 subjects (20.7%) after mean follow up of 11 + 5.5 months. Bivariate analysis revealed preoperative TAPSE, underlying etiology, severity of pulmonary hypertension preoperatively, postoperative atrial fibrilation, mean mitral valve gradient predischarge, and the presence of residual pulmonary hypertension predischarge were related with persistent pulmonary hypertension. From multivariate analysis, post operative atrial fibrillation [OR 7.3 (CI 95% 1.64-33.33, p=0.09)], mean mitral valve gradient predischarge [OR 1.67 (CI 95% 1,3-2.7, p=0.038)], and preoperative TAPSE [OR 0.143 (CI 95% 0.03-0.70, p=0.017)] were independent predictors for persistent pulmonary hypertension after mitral valve surgery.Conclusion. Persistent pulmonary hypertension was observed in 20.7% subjects after mitral valve surgery. Preoperative TAPSE, post operative atrial fibrillation, and predischarge mean mitral valve gradient were independent predictors.

Permanent pacemaker implantation following mitral valve surgery: a retrospective cohort study of risk factors and long-term outcomes

2021 ◽  
Author(s):  
Mark R Helmers ◽  
Max Shin ◽  
Amit Iyengar ◽  
Gabriel R Arguelles ◽  
Jarvis Mays ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mitral Valve ◽  
Tricuspid Valve ◽  
Mitral Valve Surgery ◽  
Permanent Pacemaker ◽  
Valve Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Valvular Surgery

Abstract OBJECTIVES Conduction disturbances requiring permanent pacemaker (PPM) implantation remain a complication following valvular surgery. PPMs confer the risk of infection, tricuspid valve regurgitation and pacing-induced cardiomyopathy. Literature examining PPM placement in mitral valve surgery (MVS) is limited. METHODS Our institutional mitral valve (MV) database was retrospectively reviewed for adult patients undergoing surgery from 2011 to 2019. Patients with preoperative PPM were excluded. Patients were stratified by the receipt of PPM following their index operations. Multivariable logistic regression was performed to determine patient and operative risk factors for PPM. Subgroup analysis was performed on patients who underwent isolated MVS. Kaplan–Meier analysis and a multivariable Cox proportional hazards model were utilized to assess the association between PPM implantation and long-term survival. RESULTS A total of 3391 (2991 non-PPM and 400 PPM) patients met the study criteria. Significant predictors of PPM included increased decade of age (odds ratio: 1.23; 95% confidence interval: 1.12–1.35), concomitant aortic (1.44; 1.10–1.90) and tricuspid valve procedures (2.21; 1.64–2.97) and prior history of myocardial infarction (1.48; 1.07–1.86). In the isolated MV repair population, annuloplasty with ring prosthesis was associated with PPM (3.09; 1.19–8.02). Patients in the replacement population did not have significant identifiable risk factors. There was no survival difference found, and postoperative PPM placement was not found to be an independent predictor of mortality. CONCLUSIONS Our primary aim was to elucidate predictors for PPM implantation in MVS and found increasing age and concomitant procedures to be risk factors. Receipt of PPM is associated with worse long-term survival but does not independently predict survival. Among patients undergoing isolated MV repair, use of an annuloplasty ring confers a higher risk of PPM compared to an annuloplasty band.

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