Mid- and long-term efficacy of mitral valve plasty versus replacement in the treatment of functional mitral regurgitation: A 10-year single-center outcome
- VernacularTitle:二尖瓣成形与置换术治疗功能性二尖瓣反流中远期疗效比较：10年单中心结果
- Author:
Hanqing LIANG
1
,
2
;
Qiaoli WAN
3
;
Tao WEI
3
;
Rui LI
3
;
Zhipeng GUO
3
;
Jian ZHANG
3
;
Zongtao YIN
3
;
Jinsong HAN
3
Author Information
1. 1. General Hospital of Northern Theater Command, The Graduate Training Base of Jinzhou Medical University, Shenyang, 110016, P. R. China 2. Department of Cardiovascular Surgery, Xuzhou First People'
2. s Hospital, Xuzhou, 221000, Jiangsu, P. R. China
3. Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China
- Publication Type:Journal Article
- Keywords:
Mitral regurgitation;
functional mitral regurgitation;
mitral valve plasty;
mitral valve replacement
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(01):108-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the mid- and long-term clinical results of mitral valve plasty (MVP) and mitral valve replacement (MVR) in the treatment of functional mitral regurgitation (FMR). Methods Patients with FMR who underwent surgical treatment in the Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command from 2012 to 2021 were collected. The patients who underwent MVP were divided into a MVP group, and those who underwent MVR into a MVR group. The clinical data and mid-term follow-up efficacy of two groups were compared. Results Finally 236 patients were included. There were 100 patients in the MVP group, including 53 males and 47 females, with an average age of (61.80±8.03) years. There were 136 patients in the MVR group, including 72 males and 64 females, with an average age of (61.29±8.97) years. There was no statistical difference in baseline data between the two groups (P＞0.05). There was no statistical difference between the two groups in the extracorporeal circulation time, aortic occlusion time, postoperative hospital and ICU stay, intraoperative blood loss, or hospitalization death (P＞0.05), but the time of mechanical ventilation in the MVP group was significantly shorter than that in the MVR group (P=0.022). The total follow-up rate was 100.0%, the longest follow-up was 10 years, and the average follow-up time was (3.60±2.55) years. There were statistical differences in the left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and cardiac function between the two groups compared with those before surgery (P<0.05). The postoperative left ventricular ejection fraction in the MVP group was statistically higher than that before surgery (P=0.002), but there was no statistical difference in the MVR group before and after surgery (P=0.658). The left atrial diameter in the MVP group was reduced compared with the MVR group (P=0.026). The recurrence rate of mitral regurgitation in the MVP group was higher than that in the MVR group, and the difference was statistically significant (10.0% vs. 1.5%, P=0.003). There were 14 deaths in the MVP group and 19 in the MVR group. The cumulative survival rate (P=0.605) and cardiovascular events-free survival rate (P=0.875) were not statistically significant between the two groups by Kaplan-Meier survival analysis. Conclusion The safety, and mid- and long-term clinical efficacy of MVP in the treatment of FMR patients are better than MVR, and the left atrial and left ventricular diameters are statistically reduced, and cardiac function is statistically improved. However, the surgeon needs to be well aware of the indications for the MVP procedure to reduce the rate of mitral regurgitation recurrence.
