Pulmonary hypertension adversely affects short- and long-term survival after mitral valve operation for mitral regurgitation: Implications for timing.

Slides:

Advertisements

Similar presentations

The “occasional open heart surgeon” revisited

Advertisements

Factors associated with postoperative atrial fibrillation and other adverse events after cardiac surgery Emmanuel Akintoye, MD, MPH, Frank Sellke, MD,

Repeat Sternotomy: No Longer a Risk Factor in Mitral Valve Surgical Procedures Mehrdad Ghoreishi, MD, Murtaza Dawood, MD, Gerald Hobbs, PhD, Chetan Pasrija,

A contemporary analysis of pulmonary hypertension in patients undergoing mitral valve surgery: Is this a risk factor? Daniel H. Enter, MD, Anthony Zaki,

The use of extended criteria donors decreases one-year survival in high-risk lung recipients: A review of the United Network of Organ Sharing Database

The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting Danny Chu, MD, Faisal.

Mitral stenosis with pulmonary hypertension: We should operate early

Trends in isolated coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons adult cardiac surgery database Andrew W. ElBardissi,

Niv Ad, MD, Rakesh M. Suri, MD, DPhil, James S

The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades Jeanne Shen, BS, Shelly Lall,

Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: A propensity score analysis Christophe de Meester, MS, Agnès Pasquet,

Predicting In-Hospital Mortality After Redo Cardiac Operations: Development of a Preoperative Scorecard Sebastian Launcelott, BA, BComm, Maral Ouzounian,

Puja Gaur, MD, Tsuyoshi Kaneko, MD, Siobhan McGurk, BS, James D

Very long-term durability of the edge-to-edge repair for isolated anterior mitral leaflet prolapse: Up to 21 years of clinical and echocardiographic results

Coarctation Long-term Assessment (COALA): Significance of arterial hypertension in a cohort of 404 patients up to 27 years after surgical repair of isolated.

Prognostic implications of pulmonary hypertension in patients with severe aortic stenosis Akin Cam, MD, Sachin S. Goel, MD, Shikhar Agarwal, MD, MPH,

Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: Changes in risks, valve types, and outcomes in the Society.

Prolonged QTc affects short-term and long-term outcomes in patients with normal left ventricular function undergoing cardiac surgery Nattachai Anantasit,

POINT: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation:

Pulmonary hypertension in valve disease: A beast of the past?

Zhe Zheng, MD, PhD, Heng Zhang, MD, PhD, Bo Xu, MBBS

Marc R. Moon, MD The Journal of Thoracic and Cardiovascular Surgery

Restrictive mitral valve annuloplasty versus mitral valve replacement for functional ischemic mitral regurgitation: An exercise echocardiographic study

Functional mitral stenosis after mitral valve repair is a true anatomic problem that originates from the time of surgery Vincent Chan, MD, MPH, Thierry.

Multilevel data analysis: What? Why? How?

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

The lord of the rings Antonio Miceli, MD, PhD

Surgical economics: MACRA, MIPS, and bundles—Lessons learned in the first 3 years of a coronary artery bypass grafting alternative payment model Daniel.

Sarah A. Schubert, MD, Leora T

Natural history of coexistent tricuspid regurgitation in patients with degenerative mitral valve disease: Implications for future guidelines Andrew B.

Mitral valve repair with the new semirigid partial Colvin–Galloway Future annuloplasty band Ruediger Lange, MD, Thomas Guenther, MD, Birgit Kiefer, MD,

Darren H. Freed, MD, PhD, FRCSC, Bruce M

The variability of the mitral valve anatomy and terminology

Does the degree of preoperative mitral regurgitation predict survival or the need for mitral valve repair or replacement in patients with anomalous origin.

Performance of the European System for Cardiac Operative Risk Evaluation II: A meta- analysis of 22 studies involving 145,592 cardiac surgery procedures

Open aortic arch reconstruction after previous cardiac surgery: Outcomes of 168 consecutive operations Eduard Quintana, MD, FETCS, Pietro Bajona, MD,

The role of cognitive dissonance in the management of functional tricuspid regurgitation at the time of degenerative mitral valve repair Rakesh M. Suri,

Mitral valve repair in heart failure: Five-year follow-up from the mitral valve replacement stratum of the Acorn randomized trial Michael A. Acker, MD,

Clinical evaluation of functional mitral stenosis after mitral valve repair for degenerative disease: Potential affect on surgical strategy Thierry G.

Clinical and hemodynamic influences of prophylactic tricuspid annuloplasty in mechanical mitral valve replacement Heemoon Lee, MD, Kiick Sung, MD, PhD,

A first start for lung transplantation?

Impact of pulmonary hypertension on outcomes after aortic valve replacement for aortic valve stenosis Spencer J. Melby, MD, Marc R. Moon, MD, Brian R.

Transcatheter aortic valve replacement and surgical aortic valve replacement: Both excellent therapies J. James Edelman, MBBS(Hons), PhD, Vinod H. Thourani,

Repeat Sternotomy: No Longer a Risk Factor in Mitral Valve Surgical Procedures Mehrdad Ghoreishi, MD, Murtaza Dawood, MD, Gerald Hobbs, PhD, Chetan Pasrija,

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

Chronic obstructive pulmonary disease severity influences outcomes after off-pump coronary artery bypass Benjamin Medalion, MD, Michael G. Katz, MD,

Conventional redo biological valve replacement over 20 years: Surgical benchmarks should guide patient selection for transcatheter valve-in-valve therapy

Nonelective cardiac surgery in the elderly: Is it justified?

Fenton H. McCarthy, MD, MS, Nimesh D. Desai, MD, PhD

Replicating the success of mitral valve repair in the aortic valve

Manuel J. Antunes, MD, PhD, DSc

Influence of experience and the surgical learning curve on long-term patient outcomes in cardiac surgery Bryan M. Burt, MD, Andrew W. ElBardissi, MD,

The Bentall procedure: Is it the gold standard

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Ralph S. Mosca, MD The Journal of Thoracic and Cardiovascular Surgery

Long-term results of Freestyle stentless bioprosthesis in the aortic position: A single- center prospective cohort of 500 patients Nicolas Amabile, MD,

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Severe tricuspid or mitral regurgitation in inoperable patients with aortic stenosis. Can we leave them alone? Juan A. Crestanello, MD The Journal of.

The future of cardiac surgery training: A survival guide

Tricuspid annulus diameter does not predict the development of tricuspid regurgitation after mitral valve repair for mitral regurgitation due to degenerative.

Improved quality and cost-effectiveness of coronary artery bypass grafting in the United States from 1988 to 2005 Howard K. Song, MD, PhD, Brian S. Diggs,

The impact of concomitant pulmonary hypertension on early and late outcomes following surgery for mitral stenosis Bo Yang, MD, PhD, Christina DeBenedictus,

Reliability of risk algorithms in predicting early and late operative outcomes in high-risk patients undergoing aortic valve replacement Todd M. Dewey,

Recovery of left ventricular function after surgical correction of mitral regurgitation caused by leaflet prolapse Rakesh M. Suri, MD, DPhil, Hartzell.

Preoperative PFTs: The answer is blowing in the wind

National trends in utilization and in-hospital outcomes of mechanical versus bioprosthetic aortic valve replacements Abby J. Isaacs, MS, Jeffrey Shuhaiber,

Chordal replacement with polytetrafluoroethylene sutures for mitral valve repair: A 25- year experience Tirone E. David, MD, Susan Armstrong, MSc, Joan.

Time-related mortality for women after coronary artery bypass graft surgery: a population-based study Veena Guru, MD, Stephen E Fremes, MD, MSc, Jack.

Intraoperative endocardial ultrasonography: Improving safety in mitral valve surgery Juan A. Crestanello, MD The Journal of Thoracic and Cardiovascular.

Presentation transcript:

Pulmonary hypertension adversely affects short- and long-term survival after mitral valve operation for mitral regurgitation: Implications for timing of surgery Mehrdad Ghoreishi, MD, Charles F. Evans, MD, Christopher R. DeFilippi, MD, Gerald Hobbs, PhD, Cindi A. Young, Bartley P. Griffith, MD, James S. Gammie, MD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 6, Pages 1439-1452 (December 2011) DOI: 10.1016/j.jtcvs.2011.08.030 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Patient population: exclusion criteria and final analysis population for cohort 1 and 2 studies. AV, Aortic valve; CABG, coronary artery bypass graft surgery; MR, mitral regurgitation; MS, mitral stenosis; MV, mitral valve; PPH, primary pulmonary hypertension; Redo, redo cardiac surgery; sPAP, systolic pulmonary artery pressure. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Hospital mortality according to preoperative PH grade (P < .0001). PH, Pulmonary hypertension. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Long-term survival according to preoperative PH. A, Actuarial survival according to a cutoff value of sPAP 40 mm Hg or greater. B, Survival according to preoperative PH grade. PH, Pulmonary hypertension; sPAP, Systolic pulmonary artery pressure. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Survival curve according to preoperative PH (sPAP ≥ 40 mm Hg) in cohort 2 (patients with isolated degenerative MR due to flail leaflet). For all patients (A) and according to preoperative PH grade (B). MR, Mitral regurgitation; PH, pulmonary hypertension; sPAP, systolic pulmonary artery pressure. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Mean sPAP at different time points. A, All patients (mean ± standard deviation sPAP at preoperative: 43 ± 16, predischarge: 39 ± 11, follow-up < 2 years: 39 ± 12, follow-up > 2 years: 38 ± 13 mm Hg). B, According to PH grade for all patients. C, For 404 patients with 2-year follow-up. Mean sPAP decreased markedly in patients with higher preoperative sPAP, but residual sPAP 40 mm Hg or greater was more common after surgery and during follow-up in these groups. Pulmonary pressures at predischarge relatively correlate with the late response of pulmonary pressure changes to surgery (no significant difference was identified in mean sPAP at predischarge and within 2 years follow-up, P = .95). ¥Median: 12 months (24 days to 24 months). §Median: 41 months (24–91 months). ∗P < .01 compared with preoperative value. MR, Mitral regurgitation; PH, pulmonary hypertension; sPAP, Systolic pulmonary artery pressure. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure 1 Kaplan–Meier survival curve according to preoperative sPAP/sBP. sPAP, Systolic pulmonary artery pressure; sBP, systolic blood pressure. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure 2 Hospital mortality according to preoperative PH grade among patients who underwent isolated MV operation for MR (n = 478). PH, Pulmonary hypertension. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Appendix Figure 3 Long-term survival according to preoperative PH among patients who underwent isolated MV operation for MR (n = 478). PH, Pulmonary hypertension. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1439-1452DOI: (10.1016/j.jtcvs.2011.08.030) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions