One-year outcomes of concomitant mitral reduction annuloplasty repair with coronary artery bypass grafting for moderate ischemic mitral regurgitation
Notice bibliographique
Résumé
Background Mitral valve repair for chronic ischemic mitral regurgitation (IMR) in the published literature has contradictory outcomes. Here, we report our center outcomes of reduction annuloplasty technique in addition to myocardial revascularization to treat ischemic IMR over a four-year period. Methods Between January 2011 and December 2014, a total of 40 patients were identified to have a reduced left ventricular ejection fraction who underwent first-time mitral valve reduction annuloplasty concomitantly with coronary artery bypass grafting to treat moderate IMR. Variations in left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), functional class, and mitral regurgitation (MR) was followed up after surgery and retrospectively analyzed. Results In our cohort, mitral reduction annuloplasty was successful in helping 33 (82%) patients to have no residual MR and to downgrade their MR from moderate (grade 3+) to trace (grade 1+) in 7 (18%) patients before leaving the operating room. A change from baseline value was observed secondary to correction of MR. At 3-months follow-up time; the mean MR grade that was 0.2 ± 0.1 by the intraoperative assessment post-bypass has increased significantly to be 1.8 ± 0.4 (p < 0.05). Similarly, at one year after surgery it increased to 1.9 ± 0.3, p < 0.05, compared to baseline value. Remarkably, our patients showed a significant increase in the mean LVEF (48 ± 1.1%, p < 0.05), at 3-month visit and 1-year visit post-surgery (47 ± 4.2%), %, p < 0.05) compared to the baseline values (39 ± 2.3%, p < 0.05 for both visits). While our patients showed gradually but non-significantly reduction in the mean LVESVI (57.6 ± 9.0 ml/m 2 , p > 0.05) at early follow-up time, mean LVESVI improved significantly to be 47.6 ± 11.0 ml/m 2 , p < 0.05 at the one year. This statistically significant increase in the LVEF% at 3-month visit, in addition to the reduction in the LVESVI after one year were capable to induce substantial clinical change in NYHA functional class , which was observed early (at 3-month visit) where 35 (88%) patients became in NYHA class I and II and later (at 1-year visit post-surgery) where 32 (80%) patients stayed in NYHA class I and II. No deaths were reported during the one-year follow-up resulting in 95% survival rate. During the one-year follow-up time, 7 (18%) were readmitted to the hospital due to non-cardiac indications. Early operative mortality (within 30 days after surgery) was 5%. One-year survival was 95%. The mean duration of follow-up was 1.1 ± 2.4 years (range, 1.0–3.5 years). Conclusions Mitral reduction annuloplasty concomitant to surgical myocardial revascularization may be sufficient to correct moderate IMR. It is associated with substantial improvement in early and intermediate-term survival rates, left ventricular functions , NYHA class and low incidence of recurrent MR.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».