» مقالات انگلیسی » A standardized repair-oriented strategy for mitral insufficiency in infants and children: Midterm functional outcomes and predictors of adverse events

A standardized repair-oriented strategy for mitral insufficiency in infants and children: Midterm functional outcomes and predictors of adverse events



شناسه مقاله
10.1016/j.jtcvs.2014.02.057
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انگلیسی

Title: A standardized repair-oriented strategy for mitral insufficiency in infants and children: Midterm functional outcomes and predictors of adverse events

Authors: David Kalfa and Mathieu Vergnat and Mohamedou Ly and Bertrand Stos and Virginie Lambert and Alban Baruteau and Emre Belli

Journal: The Journal of Thoracic and Cardiovascular Surgery

Year: 2014

Abstract:

Objective Surgical management of mitral regurgitation (MR) in children remains a challenge because of the heterogeneity of the anatomy, growth potential, and necessity to avoid valve replacement. Our objective was to assess the functional outcomes and prognostic factors of a standardized strategy of mitral valve (MV) repair for children with MR. Methods Consecutive patients aged <18 years who had undergone surgery for severe {MR} from 2001 to 2012 were studied retrospectively. The standardized repair strategy mainly included leaflet debridement, annuloplasty, and leaflet augmentation. Multivariable risk analyses for recurrent {MR} (grade > II), transmitral mean echocardiographic gradient >5 mm Hg, {MV} reoperation, replacement, and mortality were performed. Results A total of 106 patients were included (median age, 5.1 years; range, 11 days to 18 years). The mean follow-up period was 3.9 ± ۳٫۲ years (range, 2 months to 11 years). The proportion of congenital and left heart obstruction-related (left ventricular outflow tract obstruction) etiology was 49% (n = ۵۲) and 11% (n = ۱۲), respectively. {MV} repair was performed primarily in 97% of the patients. The mortality, reoperation, replacement, and {MR} rate at the last follow-up visit was 4.5% (n = ۵), ۲۳% (n = ۲۴), ۵٫۵% (n = ۶), and 17% (n = ۱۸), respectively. Actuarial survival was 93% ± ۲% at 10 years. Freedom from {MV} replacement was 95% ± ۲% and 86% ± ۷% at 5 and 15 years, respectively. Native valve preservation was obtained in 85% of the infants and 94% beyond infancy. Independent predictors of recurrent MR, {MV} reoperation, and replacement included left ventricular outflow tract obstruction etiology (hazard ratio, 45; P = .۰۰۴), associated preoperative mitral stenosis (hazard ratio, 21; P = .۰۳), and young age (hazard ratio, 1.2; P = .۰۴). Conclusions A standardized and reproducible {MV} repair strategy can achieve satisfactory functional results in infants and children with severe MR, allowing native valve preservation. The left ventricular outflow tract obstruction-related etiology was the main independent predictor of recurrent MR, {MV} reoperation, and {MV} replacement.

Keywords:

ترجمه فارسی
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عنوان: استراتژی به تعمیر گرا استاندارد برای نارسایی میترال در نوزادان و کودکان: میان دوره ای کاربردی نتایج و پیش بینی عوارض جانبی

نویسندگان: David Kalfa and Mathieu Vergnat and Mohamedou Ly and Bertrand Stos and Virginie Lambert and Alban Baruteau and Emre Belli

ژورنال: The Journal of Thoracic and Cardiovascular Surgery

سال: ۲۰۱۴

چکیده:
نتیجه گیری {MV} استراتژی تعمیر استاندارد و تجدید پذیر می تواند نتایج عملکردی رضایت بخش در نوزادان و کودکان مبتلا به MR شدید دست، اجازه می دهد حفظ دریچه بومی علت بطن چپ مجرای خروجی انسداد مربوط به پیش بینی اصلی مستقل از عود محمدرضا بود، {MV} عمل مجدد، و {MV} جایگزین
کلمات کلیدی:

سفارش ترجمه

سفارش ترجمه

توانایی ترجمه

توانایی ترجمه

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