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Indian Journal of Thoracic and Cardiovascular Surgery

Erschienen in:

18.10.2023 | Original Article

Early and long-term outcomes of mitral valve replacement with mechanical valve in rheumatic heart disease

verfasst von: Praveen Kerala Varma, Maniyal Vijayakumar, Neethu Krishna, Renjitha Bhaskaran, Rohik Micka Radhakrishnan, Rajesh Jose, Kirun Gopal, Raman Krishna Kumar

Erschienen in: Indian Journal of Thoracic and Cardiovascular Surgery | Ausgabe 2/2024

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Abstract

Background

Rheumatic fever and rheumatic heart disease is endemic in India. Mitral valve replacement with mechanical valve is the commonest surgical procedure performed in rheumatic heart disease (RHD). However, there are no studies reporting the long-term outcomes of mechanical mitral valve replacement in rheumatic heart disease from India.

Objective

The primary objective of the study was to look at the long-term survival following mechanical mitral valve replacement in RHD. The secondary objectives included follow up complications and event-free survival.

Methods

For this study, 238 patients who underwent mitral valve replacement with TTK Chitra™ valve from 1st January 2006 to 31st December 2018 for RHD were included for analysis and reporting. The median follow-up period was 3371.50 days (9.3 years). Total follow-up was 2044 patient-years.

Results

The mean age of the study population was 39.72 ± 10.48 years (range: 18–68 years). Out of 238 patients operated, 155 patients (65.12%) were alive and 69 patients (28.99%) were dead, and 14 patients (5.88%) were lost to follow-up. The operative mortality was 6 (2.52%) and the follow-up mortality was 63 (26.47%). The reasons for follow-up mortality were cardiac complications in 22 (34.9%) patients, valve-related complications in 18 (28.5%) patients, sudden unexplained death in 13 (20.6%) patients, and non-valve/ non-cardiac death in 10patients (15.8%). The one-year survival was 94.0%, five-year survival was 83.6%, ten-year survival was 70.6% and 15-year survival was 62.9%. During follow-up, valve-related events occurred in 123(52%) patients. The 15-year event-free survival was 33.0%.

Conclusions

The long term outcome of mechanical valve replacement of the mitral valve in RHD patients was less than favorable. Both cardiac complications and mechanical valve related complications reduced their survival.

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Titel: Early and long-term outcomes of mitral valve replacement with mechanical valve in rheumatic heart disease
verfasst von: Praveen Kerala Varma
Maniyal Vijayakumar
Neethu Krishna
Renjitha Bhaskaran
Rohik Micka Radhakrishnan
Rajesh Jose
Kirun Gopal
Raman Krishna Kumar
Publikationsdatum: 18.10.2023
Verlag: Springer Nature Singapore
Erschienen in: Indian Journal of Thoracic and Cardiovascular Surgery / Ausgabe 2/2024
Print ISSN: 0970-9134
Elektronische ISSN: 0973-7723
DOI: https://doi.org/10.1007/s12055-023-01615-3

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Abstract

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