Lars G. Svensson, MD, PhD, Fernando A. Atik, MD, Delos M

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Presentation transcript:

Minimally invasive versus conventional mitral valve surgery: A propensity-matched comparison Lars G. Svensson, MD, PhD, Fernando A. Atik, MD, Delos M. Cosgrove, MD, Eugene H. Blackstone, MD, Jeevanantham Rajeswaran, MSc, Gita Krishnaswamy, MS, Ung Jin, MD, A. Marc Gillinov, MD, Brian Griffin, MD, José L. Navia, MD, Tomislav Mihaljevic, MD, Bruce W. Lytle, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 4, Pages 926-932.e2 (April 2010) DOI: 10.1016/j.jtcvs.2009.09.038 Copyright © 2010 Terms and Conditions

Figure 1 Mirrored histogram of distribution of propensity scores for conventional (bars above zero line) and minimally invasive (bars below zero line) approaches. The darkened area represents matched patient pairs, showing that they cover the complete spectrum of cases. MIP, Minimally invasive valve surgery. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Figure 2 Number of patients with echocardiograms available at and beyond various time points and number of echocardiograms available for analysis. Black bars, echocardiograms; gray bars, patients. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Figure 3 Temporal pattern of postextubation forced expiratory volume in 1 second (FEV1) as a percentage of predicted value after minimally invasive (MIP) and conventional mitral valve surgery among propensity-matched patients. Solid lines are parametric estimates of temporal trend enclosed within dashed lines representing 68% confidence limits (equivalent to ±1 standard error). Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. NHANES, National Health and Nutrition Examination Survey. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Figure 4 Temporal pattern of pain score categories after minimally invasive versus conventional mitral valve surgery among propensity-matched patients. Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. Solid lines are parametric estimates of the percentage of patients in each category. A, All pain score categories. B, Proportion of patients without pain (category 0). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Figure 5 Survival after minimally invasive (MIP) and conventional mitral valve surgery among propensity-matched patients. Each symbol represents a death, positioned actuarially; vertical bars represent 68% confidence limits; and numbers in parentheses represent patients remaining at risk. Solid lines are parametric estimates enclosed within dashed lines representing 68% confidence limits (equivalent to ±1 standard error). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Figure 6 Proportion of patients with mitral regurgitation (MR) grade 3+ or 4+ after minimally invasive (MIP) and conventional mitral valve repair among propensity-matched patients. Symbols represent data grouped within time frame without regard for repeated assessment simply to provide crude verification of model fit. Solid lines are parametric estimates of the percentage of patients in MR grade 3+ or 4+ enclosed within 68% bootstrap percentile confidence limits. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Temporal pattern of postextubation forced expiratory volume in 1 second (FEV1) as a percentage of predicted value after minimally invasive (MIP) and conventional mitral valve surgery among all patients. Solid lines are parametric estimates of temporal trend enclosed within dashed lines representing 68% confidence limits (equivalent to ±1 standard error). Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. NHANES, National Health and Nutrition Examination Survey. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Temporal pattern of pain score categories after minimally invasive versus conventional mitral valve surgery among all patients. Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. Solid lines are parametric estimates of the percentage of patients in each category. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions

Survival after minimally invasive (MIP) and conventional mitral valve surgery among all patients. Each symbol represents a death, positioned actuarially; vertical bars represent 68% confidence limits; and numbers in parentheses represent patients remaining at risk. Solid lines are parametric estimates enclosed within dashed lines representing 68% confidence limits (equivalent to ±1 standard error). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 926-932.e2DOI: (10.1016/j.jtcvs.2009.09.038) Copyright © 2010 Terms and Conditions