Predictors of prognosis in patients with mild to moderate paravalvular leakage after mitral valve replacement.
J Card Surg
; 29(2): 149-54, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24734280
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate predictors of clinical events in patients with mild to moderate paravalvular leakage (PVL) after mitral valve replacement (MVR). METHODS ANDRESULTS:
We retrospectively reviewed all the medical records and echocardiography of 60 patients with PVL after MVR. After excluding 18 patients who required immediate surgical repair for severe symptoms or regurgitation and four patients with severe anemia who required transfusion, two patients with concomitant infective endocarditis, two patients with severe stenosis or regurgitation of other valves, and one patient with severe left ventricular systolic dysfunction, the remaining 33 patients who were not indicated for reoperation or immediate blood transfusion comprised the study population. During a median follow-up period of 19 months, there were 18 events, including two cardiac deaths, one noncardiac death, 13 repeat surgeries, and two admissions for heart failure. Cox regression analysis revealed that the presence of hemolytic anemia at the diagnosis of PVL was the only independent predictor of event-free survival (p=0.035). The estimated three-year event-free survival rates were 78 ± 12% in patients without hemolytic anemia and 16 ± 10% in those with hemolytic anemia (p=0.004).CONCLUSION:
Presence of hemolytic anemia was associated with poor short-term clinical outcome in mild to moderate PVL after MVR, even in the cases when the degree of anemia was not severe at the time of diagnosis. Therefore, in PVL patients after MVR with hemolytic anemia, more early aggressive therapeutic approaches should be considered, regardless of the severity of anemia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implante de Prótese de Valva Cardíaca
/
Fístula Anastomótica
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Anemia Hemolítica
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Valva Mitral
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Card Surg
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article