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Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure

Authorized Users Only
2022
Authors
Stojanović, Ivan
Okiljević, Bogdan
Radojičić, Zoran
Novaković, Aleksandra
Kaitović, Marko
Tomić, Slobodan
Article (Published version)
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Abstract
Background: Anterior mitral leaflet prolapse repair is a highly effective procedure, but despite excellent operative results still has an inferior long‐term durability when compared to posterior leaflet repair. Methods: We analysed mitral repair durability in 74 consecutive patients operated for anterior leaflet prolapse between 2010 and 2021. Their pre‐ and postoperative clinical, echocardiographic data and repair durability as well, were compared with 74 randomly assigned posterior leaflet prolapse patients who underwent valve repair during the same period. Results: While groups were of similar age, patients with anterior leaflet prolapse had an inferior preoperative status in terms of functional reserve, atrial fibrillation, operative risk, ejection fraction and had more dilated left heart chambers as well. 1, 5, and 10‐year freedom from repair failure was 87.1 ± 4.6%, 79.8 ± 6.5% and 50.7 ± 12.5% in the anterior, and 98.5 ± 1.5% respectively in the posterior leaflet group. Atrial f...ibrilation (hazard ratio [HR] 5.365; 95%; confidence interval [CI] 1.093–26.324 p = .038) and left ventricle end‐systolic diameter (HR 1.160 95%; CI 1.037–1.299 p = .010) independently predicted anterior leaflet repair failure. Receiver Operating Curve analysis established left ventricle end‐systolic diameter ≤42 mm as a cut‐off value associated with improved anterior leaflet repair durability. Accordingly, 10‐year repair durability in a subset of patients, with preserved left ventricle end‐systolic diameter (≤42 mm) was 86.4 ± 7.8%. Conclusion: Better long‐term repair durability in patients with anterior mitral leaflet prolapse and preserved sinus rhytm and left‐ventricle diameters justifies early reconstructive approach.

Keywords:
left ventricle / mitral valve repair / survival analysis
Source:
Journal of Cardiac Surgery, 2022, 37, 3567-3574
Publisher:
  • John Wiley and Sons Inc

DOI: 10.1111/jocs.16945

ISSN: 0886-0440

Scopus: 2-s2.0-85138232535
[ Google Scholar ]
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/4279
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Stojanović, Ivan
AU  - Okiljević, Bogdan
AU  - Radojičić, Zoran
AU  - Novaković, Aleksandra
AU  - Kaitović, Marko
AU  - Tomić, Slobodan
PY  - 2022
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4279
AB  - Background: Anterior mitral leaflet prolapse repair is a highly effective procedure, but despite excellent operative results still has an inferior long‐term durability when compared to posterior leaflet repair. Methods: We analysed mitral repair durability in 74 consecutive patients operated for anterior leaflet prolapse between 2010 and 2021. Their pre‐ and postoperative clinical, echocardiographic data and repair durability as well, were compared with 74 randomly assigned posterior leaflet prolapse patients who underwent valve repair during the same period. Results: While groups were of similar age, patients with anterior leaflet prolapse had an inferior preoperative status in terms of functional reserve, atrial fibrillation, operative risk, ejection fraction and had more dilated left heart chambers as well. 1, 5, and 10‐year freedom from repair failure was 87.1 ± 4.6%, 79.8 ± 6.5% and 50.7 ± 12.5% in the anterior, and 98.5 ± 1.5% respectively in the posterior leaflet group. Atrial fibrilation (hazard ratio [HR] 5.365; 95%; confidence interval [CI] 1.093–26.324 p = .038) and left ventricle end‐systolic diameter (HR 1.160 95%; CI 1.037–1.299 p = .010) independently predicted anterior leaflet repair failure. Receiver Operating Curve analysis established left ventricle end‐systolic diameter ≤42 mm as a cut‐off value associated with improved anterior leaflet repair durability. Accordingly, 10‐year repair durability in a subset of patients, with preserved left ventricle end‐systolic diameter (≤42 mm) was 86.4 ± 7.8%. Conclusion: Better long‐term repair durability in patients with anterior mitral leaflet prolapse and preserved sinus rhytm and left‐ventricle diameters justifies early reconstructive approach.
PB  - John Wiley and Sons Inc
T2  - Journal of Cardiac Surgery
T1  - Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure
IS  - 37
SP  - 3567
EP  - 3574
DO  - 10.1111/jocs.16945
ER  - 
@article{
author = "Stojanović, Ivan and Okiljević, Bogdan and Radojičić, Zoran and Novaković, Aleksandra and Kaitović, Marko and Tomić, Slobodan",
year = "2022",
abstract = "Background: Anterior mitral leaflet prolapse repair is a highly effective procedure, but despite excellent operative results still has an inferior long‐term durability when compared to posterior leaflet repair. Methods: We analysed mitral repair durability in 74 consecutive patients operated for anterior leaflet prolapse between 2010 and 2021. Their pre‐ and postoperative clinical, echocardiographic data and repair durability as well, were compared with 74 randomly assigned posterior leaflet prolapse patients who underwent valve repair during the same period. Results: While groups were of similar age, patients with anterior leaflet prolapse had an inferior preoperative status in terms of functional reserve, atrial fibrillation, operative risk, ejection fraction and had more dilated left heart chambers as well. 1, 5, and 10‐year freedom from repair failure was 87.1 ± 4.6%, 79.8 ± 6.5% and 50.7 ± 12.5% in the anterior, and 98.5 ± 1.5% respectively in the posterior leaflet group. Atrial fibrilation (hazard ratio [HR] 5.365; 95%; confidence interval [CI] 1.093–26.324 p = .038) and left ventricle end‐systolic diameter (HR 1.160 95%; CI 1.037–1.299 p = .010) independently predicted anterior leaflet repair failure. Receiver Operating Curve analysis established left ventricle end‐systolic diameter ≤42 mm as a cut‐off value associated with improved anterior leaflet repair durability. Accordingly, 10‐year repair durability in a subset of patients, with preserved left ventricle end‐systolic diameter (≤42 mm) was 86.4 ± 7.8%. Conclusion: Better long‐term repair durability in patients with anterior mitral leaflet prolapse and preserved sinus rhytm and left‐ventricle diameters justifies early reconstructive approach.",
publisher = "John Wiley and Sons Inc",
journal = "Journal of Cardiac Surgery",
title = "Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure",
number = "37",
pages = "3567-3574",
doi = "10.1111/jocs.16945"
}
Stojanović, I., Okiljević, B., Radojičić, Z., Novaković, A., Kaitović, M.,& Tomić, S.. (2022). Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure. in Journal of Cardiac Surgery
John Wiley and Sons Inc.(37), 3567-3574.
https://doi.org/10.1111/jocs.16945
Stojanović I, Okiljević B, Radojičić Z, Novaković A, Kaitović M, Tomić S. Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure. in Journal of Cardiac Surgery. 2022;(37):3567-3574.
doi:10.1111/jocs.16945 .
Stojanović, Ivan, Okiljević, Bogdan, Radojičić, Zoran, Novaković, Aleksandra, Kaitović, Marko, Tomić, Slobodan, "Clinical and echocardiographic predictors of the anterior mitral leaflet repair failure" in Journal of Cardiac Surgery, no. 37 (2022):3567-3574,
https://doi.org/10.1111/jocs.16945 . .

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