Sarah A. Schubert, MD, Leora T

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Presentation transcript:

Natural history of coexistent mitral regurgitation after aortic valve replacement Sarah A. Schubert, MD, Leora T. Yarboro, MD, Sushma Madala, MD, Karnika Ayunipudi, MD, Irving L. Kron, MD, John A. Kern, MD, Gorav Ailawadi, MD, George J. Stukenborg, PhD, Ravi K. Ghanta, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 4, Pages 1032-1042.e1 (April 2016) DOI: 10.1016/j.jtcvs.2015.12.006 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Inclusion and exclusion criteria for patients undergoing isolated AVR during the study period. Inclusion criteria: aortic valve replacement, aortic stenosis, mild or greater mitral regurgitation. Exclusion criteria: reoperative procedure, other concomitant operation (ie, coronary artery bypass grafting, aorta, additional valve procedure). AVR, Aortic valve replacement. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Estimated trends in postoperative residual MR for patients with either mild or moderate preoperative MR. Shaded areas bounding the estimated functions for each group show 95% confidence intervals. The density of echocardiograms over time in each group is represented by the array of short lines corresponding to dates of assessment in each group. Preop, Preoperative; MR, mitral regurgitation; postop, postoperative. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Survival distributions are shown, by degree of preoperative MR (mild vs moderate). Survival at 5 years postoperatively was not significantly different between patients with mild versus moderate preoperative MR. Shaded areas bounding the estimated functions for each group show 95% confidence intervals. Preop, Preoperative; MR, mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Survival analysis of patients with unchanged or improved MR after aortic valve replacement, compared with those whose MR progressed. Survival at 5 years postoperatively was significantly better for patients who had unchanged or improved MR, compared with those whose MR worsened. Long-term survival was significantly better for patients with improved MR, compared with those with worse MR. Shaded areas bounding the estimated functions for each group show 95% confidence intervals. MR, Mitral regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Summary of echocardiogram follow-up frequencies and durations. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Survival analysis of patients with unchanged or improved MR after AVR, compared with those whose MR progressed. Survival at 5 years postoperatively was significantly better for patients with unchanged or improved MR, compared with those patients whose MR worsened. Long-term survival was significantly better for patients with improved MR, compared with those with worse MR. Shaded areas bounding the estimated functions for each group show 95% confidence intervals. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 1032-1042.e1DOI: (10.1016/j.jtcvs.2015.12.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions