PDF(Pubmed)
Abstract：
UNASSIGNED: Due to rheumatic heart disease, young people are more likely to develop valvular heart disease in developing countries. In countries like Pakistan, surgeons implant more bioprosthetic mitral valves (MVs) in younger patients. However, bioprosthetic valves degenerate rapidly in younger people, leading to bioprosthetic MV dysfunction (BMVD). This study aims to evaluate the clinical characteristics and long-term outcomes of patients with bioprosthetic MV replacement (MVR) at a tertiary care hospital in a South Asian country.
UNASSIGNED: This is a retrospective observational study, conducted at a tertiary care hospital. We included a total of 502 patients who underwent bioprosthetic MVR from the year 2006 to 2020. Clinical and surgical characteristics along with transthoracic echocardiographic findings (pre-surgery and recent most follow-up studies) were noted. Follow-up data were also collected.
UNASSIGNED: Out of 502 patients, 322 (64%) were female, mean age at the time of surgery was 49.42 ± 14.56 years. Mitral regurgitation was more common, found in 279 (55.6%) patients followed by mitral stenosis in 188 (37.5%) patients. MVR was done as an elective procedure due to the New York Heart Association (NYHA) II to IV symptoms at the time of surgery in 446 (88.8%) patients. In the mean follow-up of 6.59 ± 2.99 years, BMVD was observed in 183 (36.5%) patients. However, re-do MV surgery was done in only 49 (9.8%) patients. Patients were divided into two groups based on normal functioning bioprosthetic MV and BMVD. Comparing the two groups, individuals with normal functioning bioprosthetic MV had a mean age of 51.6 ± 14.27 years, while those with BMVD had a mean age of 45.639 ± 14.33 years at the time of index surgery (P = 0.000). There were more long-term complications including heart failure (n = 16, 8.74%), atrial fibrillation (n = 11, 6.01%), and death (n = 6, 3.28%) in the BMVD group which were statistically significant.
UNASSIGNED: This study is distinct because it demonstrates the outcomes of bioprosthetic valve replacement in a relatively younger South Asian population. Due to rapid degeneration of bioprosthetic valve in younger patients, significant number of patients developed BMVD along with poor long-term clinical outcomes, even at a short follow-up period of <10 years. These findings are similar to international data and signify that mechanical MVR may be a more reasonable alternative in younger patients.
UNASSIGNED: This is a retrospective observational study, conducted at a tertiary care hospital. We included a total of 502 patients who underwent bioprosthetic MVR from the year 2006 to 2020. Clinical and surgical characteristics along with transthoracic echocardiographic findings (pre-surgery and recent most follow-up studies) were noted. Follow-up data were also collected.
UNASSIGNED: Out of 502 patients, 322 (64%) were female, mean age at the time of surgery was 49.42 ± 14.56 years. Mitral regurgitation was more common, found in 279 (55.6%) patients followed by mitral stenosis in 188 (37.5%) patients. MVR was done as an elective procedure due to the New York Heart Association (NYHA) II to IV symptoms at the time of surgery in 446 (88.8%) patients. In the mean follow-up of 6.59 ± 2.99 years, BMVD was observed in 183 (36.5%) patients. However, re-do MV surgery was done in only 49 (9.8%) patients. Patients were divided into two groups based on normal functioning bioprosthetic MV and BMVD. Comparing the two groups, individuals with normal functioning bioprosthetic MV had a mean age of 51.6 ± 14.27 years, while those with BMVD had a mean age of 45.639 ± 14.33 years at the time of index surgery (P = 0.000). There were more long-term complications including heart failure (n = 16, 8.74%), atrial fibrillation (n = 11, 6.01%), and death (n = 6, 3.28%) in the BMVD group which were statistically significant.
UNASSIGNED: This study is distinct because it demonstrates the outcomes of bioprosthetic valve replacement in a relatively younger South Asian population. Due to rapid degeneration of bioprosthetic valve in younger patients, significant number of patients developed BMVD along with poor long-term clinical outcomes, even at a short follow-up period of <10 years. These findings are similar to international data and signify that mechanical MVR may be a more reasonable alternative in younger patients.
摘要：
■由于风湿性心脏病，在发展中国家，年轻人更容易患心脏瓣膜病。在像巴基斯坦这样的国家，外科医生在年轻患者中植入更多的生物假体二尖瓣（MV）。然而,生物人工瓣膜在年轻人中迅速退化，导致生物假体MV功能障碍（BMVD）。本研究旨在评估在南亚国家的三级医院进行生物假体MV置换（MVR）患者的临床特征和长期结局。
■这是一项回顾性观察研究，在三级护理医院进行。我们纳入了从2006年到2020年接受生物假体MVR的502例患者。注意到临床和手术特征以及经胸超声心动图检查结果（手术前和最近的随访研究）。还收集了后续数据。
■在502名患者中，322人（64%）为女性，手术时的平均年龄为49.42±14.56岁.二尖瓣反流更常见，在279（55.6％）患者中发现，其次是188（37.5％）患者的二尖瓣狭窄。由于纽约心脏协会（NYHA）在446名（88.8％）患者手术时的II至IV症状，MVR作为选择性手术进行。在平均6.59±2.99年的随访中，在183例（36.5％）患者中观察到BMVD。然而,只有49例(9.8%)患者进行了重新做MV手术.根据正常功能的生物假体MV和BMVD将患者分为两组。比较两组，具有正常功能的生物假体MV的个体的平均年龄为51.6±14.27岁，而BMVD患者在初次手术时的平均年龄为45.639±14.33岁（P=0.000）。有更多的长期并发症，包括心力衰竭（n=16，8.74％），心房颤动（n=11，6.01%），BMVD组的死亡（n=6，3.28％）具有统计学意义。
■这项研究是独特的，因为它证明了在相对年轻的南亚人群中进行生物瓣膜置换的结果。由于年轻患者的生物瓣膜快速变性，大量患者发展为BMVD，长期临床预后较差，即使在<10年的短暂随访期。这些发现与国际数据相似，表明机械MVR在年轻患者中可能是更合理的选择。
■这是一项回顾性观察研究，在三级护理医院进行。我们纳入了从2006年到2020年接受生物假体MVR的502例患者。注意到临床和手术特征以及经胸超声心动图检查结果（手术前和最近的随访研究）。还收集了后续数据。
■在502名患者中，322人（64%）为女性，手术时的平均年龄为49.42±14.56岁.二尖瓣反流更常见，在279（55.6％）患者中发现，其次是188（37.5％）患者的二尖瓣狭窄。由于纽约心脏协会（NYHA）在446名（88.8％）患者手术时的II至IV症状，MVR作为选择性手术进行。在平均6.59±2.99年的随访中，在183例（36.5％）患者中观察到BMVD。然而,只有49例(9.8%)患者进行了重新做MV手术.根据正常功能的生物假体MV和BMVD将患者分为两组。比较两组，具有正常功能的生物假体MV的个体的平均年龄为51.6±14.27岁，而BMVD患者在初次手术时的平均年龄为45.639±14.33岁（P=0.000）。有更多的长期并发症，包括心力衰竭（n=16，8.74％），心房颤动（n=11，6.01%），BMVD组的死亡（n=6，3.28％）具有统计学意义。
■这项研究是独特的，因为它证明了在相对年轻的南亚人群中进行生物瓣膜置换的结果。由于年轻患者的生物瓣膜快速变性，大量患者发展为BMVD，长期临床预后较差，即使在<10年的短暂随访期。这些发现与国际数据相似，表明机械MVR在年轻患者中可能是更合理的选择。
