著者

Yichen Zhao Cheng Zhao Qing Ye Fei Li Kemin Liu Shihua Zhao Jiangang Wang

出版者

The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

雑誌

Annals of Thoracic and Cardiovascular Surgery (ISSN:13411098)

巻号頁・発行日

pp.oa.22-00213, (Released:2023-03-03)

参考文献数

30

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Purpose: This study aimed to illustrate how percutaneous balloon mitral valvuloplasty (PBMV) and mitral valve (MV) surgeries influence women of childbearing age with rheumatic mitral valve diseases (RMVDs) from two aspects, including clinical outcomes and their postoperative childbearing performances.Methods: Female patients with RMVD who were of childbearing age and underwent MV interventions between 2007 and 2019 at Beijing Anzhen Hospital were identified. Outcomes included all-cause deaths, repeated MV interventions, and atrial fibrillation. A survey about childbearing attempts and complications during pregnancy was also performed during follow-up.Results: A total of 379 patients were involved in this study, consisting of 226 cases of mitral valve replacements, 107 cases of mitral valve repairs (MVrs), and 46 cases of PBMVs. PBMV was associated with higher possibilities of repeated MV interventions (P <0.05). Postoperative childbearing attempts were more frequently observed among bioprosthesis, MVr, and PBMV (P <0.05). However, PBMV and MVr showed a higher incidence of cardiac complications during pregnancy as compared to prosthesis replacement (P <0.05).Conclusions: MVr and PBMV are not recommended to young female patients for higher incidences of postoperative complications. Safe pregnancy is more likely to be present among patients with biological prosthesis.

著者

Kemin Liu Qing Ye Yichen Zhao Cheng Zhao Li Song Jiangang Wang

出版者

The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

雑誌

Annals of Thoracic and Cardiovascular Surgery (ISSN:13411098)

巻号頁・発行日

pp.oa.22-00210, (Released:2023-03-10)

参考文献数

17

被引用文献数

1

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Purpose: This study explored the sex differences in the outcomes of degenerative mitral valve repair (MVr).Methods: From 2010 to 2019, 1069 patients who underwent MVr due to degenerative mitral disease at Beijing Anzhen Hospital were analyzed. The average patient follow-up was 5.1 years (interquartile range: 5–7 years). The primary endpoint was overall survival. Secondary endpoints were freedom from reoperation and recurrent mitral regurgitation. A propensity-matched analysis was used to compare the outcomes of males and females.Results: Females were older, had a higher prevalence of atrial fibrillation and moderate-to-severe tricuspid regurgitation, and had smaller left atrial, left ventricular end-diastolic, and left ventricular end-systolic diameters. Males were more likely to undergo concomitant coronary artery bypass grafting and had longer cardiopulmonary bypass and aortic cross-clamp times. The in-hospital mortality was <1% (10/1,069). After propensity score matching of 331 pairs of patients, most variables were well balanced. Before and after propensity score matching, the long-term survival and freedom from reoperation rates were similar. Males had higher durability after surgery compared with females.Conclusions: Females were referred to surgery later and had more complications than males. Long-term survival and freedom from reoperation rates were not significantly different between the sexes.

著者

Qing Ye Yichen Zhao Kemin Liu Cheng Zhao Yang Liu Yuqi Li Jiangang Wang

出版者

The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

雑誌

Annals of Thoracic and Cardiovascular Surgery (ISSN:13411098)

巻号頁・発行日

pp.oa.22-00033, (Released:2022-07-06)

参考文献数

24

被引用文献数

1

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Purpose: We aimed to compare the efficacy of radiofrequency ablation (RFA) in patients undergoing mitral valve (MV) surgery with or without giant left atria.Methods: This retrospective, single-center, cohort study investigated patients who underwent MV surgery and concomitant RFA from 2009 to 2019. Patients were divided into non-giant left atria (diameter ≤65 mm, n = 1543) and giant left atria (diameter >65 mm, n = 241) groups. Five-year freedom from atrial tachyarrhythmia recurrence and thromboembolic event (TE) rates were assessed with death as the competing risk factor with and without propensity-score matching.Results: Patients with giant left atria had higher mortality (10.8% versus 6.2%, P = 0.008) and readmission rates for heart failure than those without (12.0% versus 6.8%, P = 0.004). Atrial tachyarrhythmia recurrence rates were higher in patients with giant left atria than in those without (49% versus 24% at 5 years, P <0.001), but the cumulative incidence of TEs before (P = 0.944) and after (P = 0.695) propensity-score matching was comparable.Conclusions: RFA effectively prevented TEs in patients with giant left atria, despite significant atrial tachyarrhythmia recurrence. Atrial tachyarrhythmia recurrence did not increase the risk of TEs. A lower success rate should be considered when deciding whether to perform surgical ablation in patients with giant left atria.