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.
■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。