Reoperation After Mitral Valve Repair for Degenerative Disease

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Reoperation After Mitral Valve Repair for Degenerative Disease Eric Dumont, MD, A. Marc Gillinov, MD, Eugene H. Blackstone, MD, Joseph F. Sabik, MD, Lars G. Svensson, MD, PhD, Tomislav Mihaljevic, MD, Penny L. Houghtaling, MS, Bruce W. Lytle, MD The Annals of Thoracic Surgery Volume 84, Issue 2, Pages 444-450 (August 2007) DOI: 10.1016/j.athoracsur.2007.03.078 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Timing of reoperation for repair failure after mitral valve repair for degenerative disease according to mechanism of failure. Patients having both procedure-related (top line) and valve-related failure (bottom line) appear twice in these graphs. Cumulative distribution of times to failure is shown with each step representing a failure. The median time to failure is the point at which each curve crosses the 50% line. The Annals of Thoracic Surgery 2007 84, 444-450DOI: (10.1016/j.athoracsur.2007.03.078) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Re-repairs versus valve replacement for repair failure after mitral valve repair for degenerative disease by date of reoperation. Solid circles represent means by yearly groupings and the solid line is a trend line. (A) Overall results. (B) Results stratified by mechanism for repair failure. Patients experiencing both procedure-related (top line, filled circles) and valve-related mechanisms (bottom line, open circles) of failure appear in both strata. The Annals of Thoracic Surgery 2007 84, 444-450DOI: (10.1016/j.athoracsur.2007.03.078) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Freedom from reoperation after mitral valve re-repair (line). Each solid circle is a reoperation, vertical bars are asymmetric confidence limits equivalent to ± 1 standard error, and numbers in parentheses patients are remaining at risk. The Annals of Thoracic Surgery 2007 84, 444-450DOI: (10.1016/j.athoracsur.2007.03.078) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Risk-unadjusted overall survival after mitral valve (MV) reoperation for repair failure. Each open circle represents a death, vertical bars are asymmetric confidence limits (CLs) equivalent to ± 1 standard error, and numbers in parentheses are patients at risk. Solid lines are parametric estimates enclosed in CLs equivalent to ±1 standard error (dashed line). (B) Unadjusted survival stratified by approach to reoperation (repair [top set of lines] versus replacement (bottom set of lines]). Filled circles (repair) and open triangles (replacement) represent a death, vertical bars are asymmetric confidence limits (CLs) equivalent to ±1 standard error, and numbers in parentheses are patients at risk. Solid lines are parametric estimates enclosed in CLs equivalent to ±1 standard error (dashed lines). The Annals of Thoracic Surgery 2007 84, 444-450DOI: (10.1016/j.athoracsur.2007.03.078) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions