Generic placeholder image

Current Cardiology Reviews

Author(s): Christian A. McNeely and Christina M. Vassileva

DOI: 10.2174/1573403X10666140827093650

DownloadDownload PDF Flyer Cite As
Long-term Outcomes of Mitral Valve Repair Versus Replacement for Degenerative Disease: A Systematic Review

Page: [157 - 162] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

The short-term advantage of mitral valve repair versus replacement for degenerative disease has been extensively documented. These advantages include lower operative mortality, improved survival, better preservation of leftventricular function, shorter post-operative hospital stay, lower total costs, and fewer valve-related complications, including thromboembolism, anticoagulation-related bleeding events and late prosthetic dysfunction. More recent written data are available indicating the long-term advantage of repair versus replacement. While at some institutions, the repair rate for degenerative disease may exceed 90%, the national average in 2007 was only 69%. Making direct comparisons between mitral valve repair and replacement using the available studies does present some challenges however, as there are often differences in baseline characteristics between patient groups as well as other dissimilarities between studies. The purpose of this review is to systematically summarize the long-term survival and reoperation data of mitral valve repair versus replacement for degenerative disease. A PubMed search was done and resulted in 12 studies that met our study criteria for comparing mitral valve repair versus replacement for degenerative disease. A systematic review was then conducted abstracting survival and reoperation data.

Keywords: Degenerative mitral valve disease, long-term survival mitral valve repair, mitral valve replacement, myxomatous degeneration.

Graphical Abstract

[1]
Enriquez-Sarano M, Akins CW, Vahanian A. Mitral regurgitation. Lancet 2009; 373: 1382-94.
[2]
Olson LJ, Subramanian R, Achermann DM, et al. Surgical pathology of the mitral valve: a study of 712 cases spanning 21 years. Mayo Clin Proc 1987; 62(1): 22-34.
[3]
Anyawu AC, Adams DH. Etiologic Classification of Degenerative Mitral Valve Disease: Barlow’s Disease and Fibroeslastic Deficiency. Semin Thorac Cardiovasc Surg 2007; 19: 90-6.
[4]
Chikwe J, Adams DH. State of the art: degenerative mitral valve disease. Heart Lung Circ 2009; 18(5): 319-29.
[5]
Grande-Allen KJ, Griffin BP, Ratliff NB, Cosgrove DM, Vesely I. Glycosaminoglycan profiles of myxomatous mitral leaflets and chordae parallel the severity of mechanical alterations. J Am Coll Cardiol 2003; 42: 271-7.
[6]
Gammie JS, Sheng S, Griffith BP, et al. Trends in mitral valve surgery in the United States: results from The Society of Thoracic Surgeons adult cardiac database. Ann Thorac Surg 2009; 87: 1431-9.
[7]
Christina MV, Theresa B, Stephen M, Stephen H. Impact of hospital annual mitral volume on mitral valve repair rates and mortality. J Heart Valve Dis 2012; 21(1): 41-7.
[8]
Chatterjee S, Rankin JS, Gammie JS, et al. Isolated mitral valve surgery risk in 77,836 patients from the Society of Thoracic Surgeons database. Ann Thorac Surg 2013; 96(5): 1587-94.
[9]
Christina MV, Gregory M, Christian M, et al. Long term survival of patients undergoing mitral valve repair and replacement: a longitudinal analysis of Medicare fee-for-service beneficiaries. Circulation 2013; 127(18): 1870-6.
[10]
Fedak P, McCarthy PM, Bonow R. Evolving Concepts and Technologies in Mitral Valve Repair. Circulation 2008; 117: 963-74.
[11]
Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg 2006; 82: 819-26.
[12]
Mohty D, Orszulak TA, Schaff HV, et al. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation 2001; 104(12 Suppl. 1): 11-7.
[13]
Daneshmand MA, Milano CA, Rankin JS, et al. Mitral valve repair for degenerative disease: A 20-year experience. Ann Thorac Surg 2009; 88: 1828-37.
[14]
Enriquez-Sarano M, Schaff HV, Orszulak TA, et al. Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. Circulation 1995; 91: 1022-8.
[15]
LaPar D, Hennessy S, Fonner E, et al. Does Urgent or Emergent Status Influence Choice in Mitral Valve Operations? An Analysis of Outcomes From the Virginia Cardiac Surgery Quality Initiative. Ann Thorac Surg 2010; 90(1): 153-60.
[16]
Akins CW, Hilgenberg AD, Buckley MJ, et al. Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg 1994; 58: 668-76.
[17]
Christina MV, John S, Theresa B, Stephen M, Stephen H. Cost Analysis of Isolated Mitral Valve Surgery in the United States. Ann Thorac Surg 2012; 94(5): 1429-36.
[18]
Gillinov AM, Cosgrove DM, Blackstone EH, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg 1998; 116: 734-43.
[19]
Tribouilloy CM, Enriquez-Sarano M, Schaff HV, et al. Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. Circulation 1999; 99: 400-5.
[20]
Enriquez-Sarano M, Tajik AJ, Schaaf HV, Orszulak TA, Bailey KR, Frye RL. Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 1994; 90: 830-7.
[21]
David TE, Ivanov J, Armstrong S, Rakowski H. Late outcomes of mitral valve repair for floppy valves: Implications for asymptomatic patients. J Thorac Cardiovasc Surg 2003; 125: 1143-52.
[22]
Zhou YX, Leobon B, Berthoumieu P, et al. Long-term outcomes following repair or replacement in degenerative mitral valve disease. Thorac Cardiovasc Surg 2010; 58: 415-21.
[23]
Song HK, Grab JD, O’Brien SM, Welke KF, Edwards F, Ungerleider RM. Gender differences in mortality after mitral valve operation: evidence for higher mortality in perimenopausal women. Ann Thorac Surg 2008; 85: 2040-5.
[24]
Hansen L, Winkel S, Kuhr J, Bader R, Bleese N, Riess FC. Factors influencing survival and postoperative quality of life after mitral valve reconstruction. Eur J Cardiothorac Surg 2010; 37: 635-44.
[25]
Nagendran J, Norris C, Maitland A, Koshal A, Ross DB. Is mitral valve surgery safe in octogenarians? Eur J Cardiothorac Surg 2005; 28: 83-7.
[26]
Enriquez-Sarano M, Avierinos J-F, Messika-Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med 2005; 352: 875-83.
[27]
Vassileva CM, McNeely C, Mishkel G, Boley T, Markwell S, Hazelrigg S. Gender differences in long-term survival of Medicare beneficiaries undergoing mitral valve operations. Ann Thorac Surg 2013; 96(4): 1367-73.
[28]
Gogbashian A, Sepic J, Soltesz EG, Nascimben L, Cohn LH. Operative and long-term survival of elderly is significantly improved by mitral valve repair. Am Heart J 2006; 151(6): 1325-33.
[29]
Gillinov AM, Blackstone EH, Nowicki ER, et al. Valve repair versus valve replacement for degenerative mitral valve disease. J Thorac Cardiovasc Surg 2008; 135: 885-93.
[30]
Lee E, Shapiro L, Wells F. Superiority of mitral valve repair in surgery for degenerative mitral regurgitation. Eur Heart J 1997; 18: 655-63.
[31]
Gillinov AM, Faber C, Houghtaling PL, et al. Repair versus replacement for degenerative mitral valve disease with coexisting ischemic heart disease. J Thorac Cardiovasc Surg 2003; 125: 1350-62.
[32]
Chikwe J, Goldstone AB, Passage J, et al. A propensity score-adjusted retrospective comparison of early and mid-term results of mitral valve repair versus replacement in octogenarians. Eur Heart J 2011; 32(5): 618-26.
[33]
Dumont E, Gillinov AM, Blackstone NW, et al. Reoperation after mitral valve repair for degenerative disease. Ann Thorac Surg 2007; 84: 444-50.
[34]
Suri RM, Schahh HV, Dearani JA, et al. Recurrent mitral regurgitation after repair: should the mitral valve be rerepaired? J Thorac Cardiovasc Surg 2006; 132: 1390-7.
[35]
Zegdi R, Sleilaty G, Latrémouille C, et al. Reoperation for failure of mitral valve repair for degenerative disease: a single-center experience. Ann Thorac Surg 2008; 86: 1480-4.
[36]
Cohn LH, Couper GS, Aranki SF, Rizzo RJ, Kinchla NM, Collins JJ. Long-term results of mitral valve reconstruction for regurgitation of the myxomatous mitral valve. J Thorac Cardiovasc Surg 1994; 107: 143-51.