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Survival Advantage and Improved Durability of Mitral Repair for Leaflet Prolapse Subsets in the Current Era  Rakesh M. Suri, MD, DPhil, Hartzell V. Schaff,

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Presentation on theme: "Survival Advantage and Improved Durability of Mitral Repair for Leaflet Prolapse Subsets in the Current Era  Rakesh M. Suri, MD, DPhil, Hartzell V. Schaff,"— Presentation transcript:

1 Survival Advantage and Improved Durability of Mitral Repair for Leaflet Prolapse Subsets in the Current Era  Rakesh M. Suri, MD, DPhil, Hartzell V. Schaff, MD, Joseph A. Dearani, MD, Thoralf M. Sundt, MD, Richard C. Daly, MD, Charles J. Mullany, MB, MS, Maurice Enriquez-Sarano, MD, Thomas A. Orszulak, MD  The Annals of Thoracic Surgery  Volume 82, Issue 3, Pages (September 2006) DOI: /j.athoracsur Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Probability of survival (death from any cause) among patients having mitral valve repair versus replacement divided into leaflet prolapse groups. Zero time on abscissa represents time of surgery and numbers at the bottom indicate patients at risk. (solid line = repair; broken line = replacement; AL = anterior leaflet; BL = bileaflet; HR = hazard ratio for survival of replacement group compared with repair group; PL = posterior leaflet.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Probability of reoperation (mitral specific) after mitral valve repair versus replacement (biological or mechanical prosthesis). Zero time on abscissa represents date of operation and numbers at the bottom of the figure represent patients at risk. (Heavy solid line = biological prosthesis, HR = 2.4, *p = ; light solid line = mechanical prosthesis, HR = 0.7; broken line = repair; HR=hazard ratio for reoperation compared with repair group.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Risk of reoperation (mitral specific) after mechanical mitral valve replacement (light solid line} versus repair subsets: isolated AL (dashed line), PL (dotted line), or BL (heavy solid line). The analysis is divided into three phases: A: overall 1980 to 2000; B: 1980 to 1989 (1980s); and C: 1990 to Zero time on abscissa represents date of operation and numbers at the bottom of the figure represent patients at risk. (AL = anterior leaflet; BL = bileaflet; HR=hazard ratio for reoperation compared with mechanical replacement group; PL = posterior leaflet.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Linearized risk of reoperation (mitral specific) for patients undergoing surgical correction of MR in the 1990s. Results from the current era demonstrate that PL repair has the lowest risk of reoperation at 0.5% per year followed by mechanical valve replacement (0.66% per year), BL repair (0.92% per year), and AL repair (1.64% per year). (Filled bars = repair groups; unfilled bar = mechanical replacement group; AL = anterior leaflet; BL = bileaflet; MR = mitral repair; PL = posterior leaflet.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions


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