Nationwide cohort study of mitral valve repair versus replacement for infective endocarditis

The Journal of Thoracic and Cardiovascular Surgery
Hsiu-An LeeShao-Wei Chen

Abstract

The feasibility and long-term outcomes of mitral valve (MV) repair in patients with infective endocarditis (IE) remain unclear. Using Taiwan's National Health Insurance Research Database, we identified 1999 patients who underwent MV surgery for IE during 2000 to 2013. The patients were more likely to have undergone valve replacement (1575 patients; 78.8%) than valve repair (424 patients; 21.2%). After 1:1 propensity score matching, 352 patients in each group were included for analysis. Perioperative outcomes and late composite end points, comprising all-cause mortality, MV reoperation, any stroke, major bleeding, and readmission for heart failure, were compared. Patients who received MV repair had fewer perioperative complications, lower in-hospital mortality rates (6.3% vs 10.8%; P = .031), and lower risks of late mortality (hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.44-0.80), and composite end point (HR, 0.67; 95% CI, 0.52-0.87) during a mean follow-up of 4.8 years. Subgroup analysis revealed a trend in which the beneficial effect of MV repair was not apparent when surgeries were performed in hospitals within the lowest volume quartile (P for interaction = .091). In patients who underwent surgery during active I...Continue Reading

Citations

Jun 2, 2020·Expert Review of Cardiovascular Therapy·Sylvie Di Filippo
Mar 7, 2020·Scientific Reports·Ching-Chang ChenShao-Wei Chen
Sep 4, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Takashi Kunihara
Aug 8, 2020·Asian Cardiovascular & Thoracic Annals·Yukikatsu OkadaYu Shomura
Mar 23, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Mu-Chieh ChiShao-Wei Chen
Apr 26, 2021·Cardiology Clinics·Yukikatsu OkadaTakeshi Kitai
Nov 7, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hsiu-An LeeShao-Wei Chen
May 2, 2021·European Journal of Clinical Investigation·Vesa AnttilaVille Kytö
May 19, 2021·Seminars in Thoracic and Cardiovascular Surgery·Ari A Mennander
Jul 2, 2021·Seminars in Thoracic and Cardiovascular Surgery·Mark R HelmersPavan Atluri
Jul 29, 2021·JACC. Case Reports·Lauren A WeberLindsey Prescher
Mar 20, 2019·The Journal of Thoracic and Cardiovascular Surgery·Francesco Nappi, Cristiano Spadaccio
Mar 20, 2019·The Journal of Thoracic and Cardiovascular Surgery·Manuel J Antunes
Apr 6, 2019·The Journal of Thoracic and Cardiovascular Surgery·Tomasz A Timek
Apr 14, 2019·The Journal of Thoracic and Cardiovascular Surgery·Shao-Wei ChenVictor Chien-Chia Wu
Sep 26, 2021·The Annals of Thoracic Surgery·I-Hsien LiShao-Wei Chen
Jan 14, 2022·Journal of Cardiac Surgery·Michele Di MauroRoberto Lorusso

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