Study Summary Conclusions
Hakimeh Sadeghian et al.69 Prospective study, CABG plus MV replacement or MV repair were performed in 49 patients with coronary heart disease complicated with moderate to severe IMR. The average follow-up period was 18.89±2.1 months. The early mortality of the repair group was higher than that of the replacement group.
Michael A. Acker et al.64 Prospective study, in 251 patients with severe IMR, MV repair or chordal-sparing replacement was performed. The primary end point was the left ventricular end-systolic volume index (LVESVI) at 12 months. The moderate or severe recurrence rate of mitral regurgitation in the repair group was higher than that in the replacement group at 12 months. Replacement provided a more lasting correction of mitral regurgitation.
Ahmet Rüçhan Akar et al.61 Retrospective study, 146 patients underwent MV surgery from January, 2004 to January, 2009. The average follow-up time was 586±413 days. MV repair is associated with acceptable surgical mortality, satisfactory medium term survival and better conserve of LV function.
Carlo Fino et al.62 Retrospective study, 121 patients with significant chronic IMR, who underwent MV repair (n=62) or MV replacement (n=59), between 2005 and 2011. A resting echocardiogram and a 6-minute walking test were taken preoperatively and repeated at 41±16.5 months. For chronic IMR, MV replacement versus MV repair was associated with better postoperative exercise hemodynamic performance and long-term functional ability.
Zhibing Qiu et al.65 Retrospective study, 218 patients underwent either MV repair (n=112) or MV replacement (n=106). Intraoperative echocardiography and follow-up. For most severe IMR patients with LV dysfunction, MV repair is preferred. However, for severe IMR patients with LV dysfunction, the long-term benefit of MV repair is not as good as MV replacement.
A. Marc Gillinov et al.63 Retrospective study, 482 patients with IMR underwent either valve repair (n = 397) or valve replacement (n = 85) from 1985 through 1997. Most IMR patients benefited from MV repair. Survival rates after repair and replacement were similar in the most complex, high-risk settings.
Simon Maltais et al.71 Retrospective study, 387 patients underwent combined CABG and MV surgery, MV repair in 302 (78%) and MV replacement in 85 (22%) patients from 1993 to 2007. The survival rate after combined operation was compromised and mostly influenced by the related factors of patients’ condition during operation. The specifics of MV repair and replacement did not seem to affect survival.
Christos G et al.66 Prospective study, 251 patients with severe IMR underwent MV repair (n=126) or MV replacement (n=125). The LVESVI was measured at 1 and 2 years post-operation. MV repair was associated with a significantly higher incidence of moderate or severe recurrent MR and heart failure.
Roberto Lorusso et al.67 Retrospective study, from 1996 to 2011, 1006 patients with chronic IMR and LV dysfunction underwent surgery in 13 Italian institutions. 298 (29.6%) patients received MV replacement and 708 (70.4%) patients received MV repair. Intraoperative echocardiography and follow-up. For patients with chronic IMR and impaired LV function, MV replacement is an appropriate choice. The rate of valvular related complications was comparable and reoperation was not required.
Antonio Lio et al.70 Retrospective study, from July 2002 to February 2011, 126 patients with IMR and LVEF <40% underwent MV repair (98,78%) or MV replacement (28,22%). In CABG patients with IMR and depressed LVEF, MV repair was not superior to MV replacement in terms of early mortality and mid-term survival rate.
D Goldstein et al.68 Prospective study, 251 patients with severe IMR underwent MV repair or chordal-sparing replacement. The primary end point was the LVESVI at 2 years. Mitral regurgitation had a higher recurrence rate in the repair group, leading to more heart failures-related adverse events and cardiovascular admissions.
V Shumavets et al.72 Retrospective study, from 2000 to 2012, 870 patients with coronary artery diseases and significant IMR underwent CABG+MV repair (n=787) or CABG+MV replacement (n=83). For patients with severe ischemic LV injury, MV replacement and repair did not seem to affect survival, which is largely dependent on the factors related to the patient’s condition during surgery.