dc.contributor.author |
Remenyi, B |
en |
dc.contributor.author |
Webb, Rachel |
en |
dc.contributor.author |
Gentles, T |
en |
dc.contributor.author |
Russell, P |
en |
dc.contributor.author |
Finucane, K |
en |
dc.contributor.author |
Lee, M |
en |
dc.contributor.author |
Wilson, N |
en |
dc.date.accessioned |
2017-08-16T03:24:31Z |
en |
dc.date.issued |
2013-04 |
en |
dc.identifier.citation |
World Journal for Pediatric and Congenital Heart Surgery 4(2):155-164 Apr 2013 |
en |
dc.identifier.issn |
2150-1351 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/35134 |
en |
dc.description.abstract |
BACKGROUND: Mitral valve (MV) repair offers potential advantages over replacement in patients with rheumatic heart disease (RHD). We present the first long-term study that compares MV repair with replacement in children with RHD. METHODS AND RESULTS: Single institute retrospective review of patients with RHD under 20 years of age, who underwent their first isolated MV surgery between 1990 and 2006. Of the 81 patients, 98% were Māori or Pacific Islander. The median age was 12.7 (3-19) years. The MV was repaired in 59%, a mechanical valve replacement (MVR) took place in 35% and bioprosthetic valve replacement in 6% of the patients. Follow-up data were available for 91.4% of the patients with mean follow-up of 7.6 years (range 0-19.4 years), a total of 620 patient years. Actuarial survival at 10 and 14 years for patients with MVR was 79% and 44%, compared to 90% and 90% for patients who underwent repair (P = .06). Actuarial freedom from late reoperation at 10 and 14 years for patients with MVR was 88% and 73%, compared to 76% and 76% for patients with repair (P = .52). Actuarial freedom from thrombotic, embolic, and hemorrhagic events at 10 and 14 years for patients with MVR was 63% and 45%, compared to 100% and 100% for patients with repair P < .01). CONCLUSION: This study shows that MV repair is superior to replacement for RHD in the young with follow-up to 19 years. Repair offers a survival advantage, greater freedom from valve-related morbidity, and long-term durability that equals that of MVR. |
en |
dc.format.medium |
Print |
en |
dc.language |
eng |
en |
dc.publisher |
Sage Periodicals Press |
en |
dc.relation.ispartofseries |
World Journal for Pediatric and Congenital Heart Surgery |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.subject |
Mitral Valve |
en |
dc.subject |
Humans |
en |
dc.subject |
Rheumatic Heart Disease |
en |
dc.subject |
Heart Valve Diseases |
en |
dc.subject |
Postoperative Complications |
en |
dc.subject |
Treatment Outcome |
en |
dc.subject |
Heart Valve Prosthesis Implantation |
en |
dc.subject |
Survival Rate |
en |
dc.subject |
Survival Analysis |
en |
dc.subject |
Retrospective Studies |
en |
dc.subject |
Follow-Up Studies |
en |
dc.subject |
Adolescent |
en |
dc.subject |
Child |
en |
dc.subject |
Child, Preschool |
en |
dc.subject |
Survivors |
en |
dc.subject |
New Zealand |
en |
dc.subject |
Female |
en |
dc.subject |
Male |
en |
dc.subject |
Young Adult |
en |
dc.subject |
Mitral Valve Annuloplasty |
en |
dc.title |
Improved long-term survival for rheumatic mitral valve repair compared to replacement in the young |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1177/2150135112474024 |
en |
pubs.issue |
2 |
en |
pubs.begin-page |
155 |
en |
pubs.volume |
4 |
en |
dc.rights.holder |
Copyright: Sage Periodicals Press |
en |
dc.identifier.pmid |
23799728 |
en |
pubs.end-page |
164 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
607271 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Paediatrics Child & Youth Hlth |
en |
dc.identifier.eissn |
2150-136X |
en |
pubs.record-created-at-source-date |
2017-08-16 |
en |
pubs.dimensions-id |
23799728 |
en |