초록접수 현황
| 17F-205 | 구연 발표 |
Long-term Outcomes of Mitral Valve Repair for Degenerative Mitral Regurgitation using Rigid or Flexible Annuloplasty Ring
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Byung-Chul Chang
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : To compare the long-term clinical outcomes of mitral valve repair for degenerative mitral regurgitation (MR) between rigid and flexible annuloplasty ring.
Methods : From January 1995 to December 2009, 496 patients underwent mitral repair for degenerative MR, and 457 patients were performed ring annuloplasty either rigid (Carpentier-ring, n=257, C-group) or flexible (Duran-ring, n=200, D-group) ring. The mean follow-up duration was 12.2±4.5 years and the mean echocardiographic follow-up duration was 7.3±5.4 years.
Results : The mean age was 52.3 years and 258 (56.5%) were male. Baseline characteristics and pre-operative echocardiographic data were comparable between the groups. D-group had longer aortic cross clamp time and more residual MR at operating room than C-group. 20-year overall survival was similar between the groups (65.3±5.7% in C-group vs. 64.6±5.9% in D-group, p=0.954) and freedom from recurrent MR (≥2) was also similar between the groups (78.8±4.4% in C-group vs. 74.2±6.6%, p=0.434). And freedom from mitral re-operation was significantly higher in C-group (95.5±1.7% vs. 88.1±3.1%, p=0.036). Both groups showed similar left ventricular remodeling, but D-group showed significantly higher mean diastolic pressure gradient than C-group (3.93±1.60mmHg in C-group vs. 4.96±2.90mmHg in D-group, p<0.001). Multivariate analysis showed that ring type was not a predictor of recurrent MR, mitral re-operation, or late death.
Conclusion : There were no significant differences in overall survival or recurrent MR between the rigid and flexible ring. But Duran-ring increased the risk of late mitral valve re-operation because of the functional mitral stenosis.
Methods : From January 1995 to December 2009, 496 patients underwent mitral repair for degenerative MR, and 457 patients were performed ring annuloplasty either rigid (Carpentier-ring, n=257, C-group) or flexible (Duran-ring, n=200, D-group) ring. The mean follow-up duration was 12.2±4.5 years and the mean echocardiographic follow-up duration was 7.3±5.4 years.
Results : The mean age was 52.3 years and 258 (56.5%) were male. Baseline characteristics and pre-operative echocardiographic data were comparable between the groups. D-group had longer aortic cross clamp time and more residual MR at operating room than C-group. 20-year overall survival was similar between the groups (65.3±5.7% in C-group vs. 64.6±5.9% in D-group, p=0.954) and freedom from recurrent MR (≥2) was also similar between the groups (78.8±4.4% in C-group vs. 74.2±6.6%, p=0.434). And freedom from mitral re-operation was significantly higher in C-group (95.5±1.7% vs. 88.1±3.1%, p=0.036). Both groups showed similar left ventricular remodeling, but D-group showed significantly higher mean diastolic pressure gradient than C-group (3.93±1.60mmHg in C-group vs. 4.96±2.90mmHg in D-group, p<0.001). Multivariate analysis showed that ring type was not a predictor of recurrent MR, mitral re-operation, or late death.
Conclusion : There were no significant differences in overall survival or recurrent MR between the rigid and flexible ring. But Duran-ring increased the risk of late mitral valve re-operation because of the functional mitral stenosis.
책임저자: Byung-Chul Chang
Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac