- 著者
- Nobuyuki Kagiyama Misako Toki Akihiro Hayashida Minako Ohara Atsushi Hirohata Keizo Yamamoto Toshinori Totsugawa Taichi Sakaguchi Kiyoshi Yoshida Mitsuaki Isobe
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.81, no.11, pp.1730-1735, 2017-10-25 (Released:2017-10-25)
- 参考文献数
- 26
- 被引用文献数
- 6 8
Background:As mitral valve (MV) repair for Barlow’s disease remains surgically challenging, it is important to distinguish Barlow’s disease from fibroelastic deficiency (FED) preoperatively. We hypothesized that the prolapse volume to prolapse height ratio (PV-PH ratio) may be useful to differentiate Barlow’s disease and FED.Methods and Results:In 76 patients with MV prolapse who underwent presurgical transesophageal echocardiography, the 3D MV morphology was quantified: 19 patients were diagnosed with Barlow’s disease and 57 with FED. The patients with Barlow’s disease had greater prolapse volume and height than the patients with FED, as well as greater PV-PH ratio (0.61±0.35 vs. 0.17±0.10, P<0.001). Receiver-operating characteristic analysis revealed that with a cutoff value of 0.27, the PV-PH ratio differentiated Barlow’s disease from FED with 84.2% sensitivity and 84.2% specificity. Net reclassification improvement showed that the differentiating ability of the PV-PH ratio was significantly superior to prolapse volume (1.30, P<0.001). After being adjusted by each of prolapse volume and height, annular area and shape, and the number of prolapsed segments, the PV-PH ratio had an independent association with Barlow’s disease.Conclusions:The PV-PH ratio was able to differentiate Barlow’s disease from FED with high accuracy. 3D quantification including this value should be performed before MV repair.
- 著者
- Yasushi Yoshikawa Yukikatsu Okada Yutaka Okita Hitoshi Yaku Junjiro Kobayashi Hideyuki Uesugi Shuichiro Takanashi Toshiaki Ito Tatsuya Nakao Tadaaki Koyama Taichi Sakaguchi Kouji Yamamoto Yoshiki Sawa
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.86, no.3, pp.449-457, 2022-02-25 (Released:2022-02-25)
- 参考文献数
- 24
- 被引用文献数
- 5
Background:This study retrospectively evaluated the long-term patient outcomes and durability of the Mosaic mitral porcine bioprosthesis in the Japan Mosaic valve long-term multicenter study.Methods and Results:The medical records of 390 patients who underwent mitral valve replacement with the Mosaic bioprosthesis at 10 centers in Japan (1999–2014) were reviewed. Patient data were collected using the Research Electronic Data Capture software. Patient survival was determined using the Kaplan-Meier method. Freedom from structural valve deterioration (SVD) and valve-related reoperation and death were determined using actuarial methods. The median (interquartile range [IQR]) age of the cohort was 73 (69–77) years. The median (IQR) follow-up period was 4.83 (1.84–8.26) years. The longest follow-up period was 15.8 years. The 30-day mortality rate was 5.4%. The 12-year actuarial survival rate was 54.1±4.5%, and the freedom from valve-related death was 85.3±3.4%. The freedom from reoperation at 12 years was 74.3±5.7%. The freedom from SVD at 12 years was 81.4±6.6% for patients aged ≥65 years and 71.6±11.1% for those aged <65 years. The median (IQR) mean pressure gradient was 4.1 (3.0–6.0) and 5.6 (4.0–6.7) mmHg at 1 and 10 years, respectively. The median (IQR) effective orifice area was 1.7 (1.4–2.0) and 1.4 (1.2–1.6) cm2at 1 and 10 years, respectively.Conclusions:The Mosaic porcine bioprosthesis offered satisfactory long-term outcomes for up to 12 years.