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Impact of intraoperative echocardiography/surgery team on successful mitral valve repair: a community hospital experience.
- Source :
-
The Journal of heart valve disease [J Heart Valve Dis] 2005 May; Vol. 14 (3), pp. 325-30; discussion 330-1. - Publication Year :
- 2005
-
Abstract
- Background and Aim of the Study: Mitral valve (MV) repair is generally accepted as the preferred treatment of mitral regurgitation (MR) with MV prolapse secondary to myxomatous mitral valve disease (MMVD). However, the incidence of successful valve repair is variable between hospitals and among different surgeons at one hospital, and often results in needless MV replacement. The study aim was to measure the impact of a dedicated echocardiography/surgery team on MV repair at a community hospital.<br />Methods: The outcome was analyzed of a group of 116 consecutive patients with severe MR secondary to MMVD who underwent surgery by the same surgeon over a six-year period. A dedicated team approach, comprising one echocardiographer and one surgeon was established in January 1999. The results of MV repair between 1996 and 1998 (group I; n = 37) were compared to results obtained between 1999 and 2001 (group II; n = 79).<br />Results: In group I, MV repair was attempted in 25 patients (67.6%) and was successful in 21 (56.8%). In group II, MV repair was attempted in 68 patients (86.1%) and was successful in 67 (84.8%). The success rate between groups was significantly (p = 0.001) different. The rate of successful MV repair in patients with a diffusely redundant prolapsing valve involving both leaflets and multiple segments with chordae elongation was significantly higher in group II (14/20; 70%) than in group I (1/6; 14.3%) (p = 0.011).<br />Conclusion: A greater incidence of successful MV repair, even with more diffuse pathology of MMVD, was realized following the institution of dedicated echocardiography/surgery team at a community hospital. It is proposed that a combination of dedicated intraoperative echocardiography and surgical expertise is required for optimal results in MV repair.
- Subjects :
- Aged
Chordae Tendineae pathology
Chordae Tendineae surgery
Female
Heart Valve Prosthesis Implantation
Hospitals, Community
Humans
Male
Middle Aged
Mitral Valve pathology
Mitral Valve surgery
Mitral Valve Insufficiency diagnostic imaging
Mitral Valve Prolapse diagnostic imaging
Patient Care Team
Reoperation
Retrospective Studies
Treatment Outcome
Echocardiography, Transesophageal
Intraoperative Care
Mitral Valve Insufficiency surgery
Mitral Valve Prolapse surgery
Ultrasonography, Interventional
Subjects
Details
- Language :
- English
- ISSN :
- 0966-8519
- Volume :
- 14
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Journal of heart valve disease
- Publication Type :
- Academic Journal
- Accession number :
- 15974526