Avtor/Urednik		Geršak, Borut; Frljak, Sabina; Pohar, Maja; Stare, Janez
Naslov		Chronic ischemic mitral regurgitation - short and long-term results of various surgical interventions
Prevedeni naslov		Kronična ishemična mitralna insuficienca - kratkoročni in dolgoročni rezultati različnih kirurških intervencij
Tip		članek
Vir		Slov Kardiol
Vol. in št.		Letnik 3, št. 2
Leto izdaje		2006
Obseg		str. 102-5
Jezik		eng
Abstrakt		The survival rates of 301 patients operated for chronic ischemic mitral valve insufficiency (Chronic IMR) in comboation with surgical revascularization (CABG) at our center between the years 1990 and 2002 were analyzed. Early mortality was 11.2% (34 patients), while late mortality was 20.5% (62 patients). Three different surgical techniques were used: CABG without any mitral valve intervention (CABG - MI), No. = 93, CABG with mitral valve repair (CABG - PVM), No. = 117 and CABG with mitral valve replacement (CABG - MVR), No. = 91. In the CABG - MI group there were more patients with good LVEF, whereas in the CABG - PVM group there were more patients with poor LVEF, and in the group CABG - MVR the distribution of good, intermediate and poor LVEF was almost equal - the results are statistically significant (p = 0.0086). The association with the type of operation and early mortality is statistically significant (p = 0.0124): CABG - MI = 3%, CABG - MVR = 15% and CABG - PVM = 15%. The association with LIMA use and early mortality has borderline significance, going in favour of LIMA use (p = 0.0513). The Cox proportional hazards model showed association with the type of operation and LIMA use for late mortality. The CABG - MI group had the better long-term outcome, whereas the CABG - MVR and CABG - PVM groups had significantly higher risk. The hazard ratio for CABG - MVR compared to CABG - MI is 2.55 (95% confidence interval) and 2.77 compared to CABG - PVM (95% confidence interval). The LIMA group had a statistically significant lower risk; the hazard ratio was 0.48% (95% confidence interval). In conclusion, the results show the need for LIMA use as an important factor for long-term survival in patients with chronic IMR. (Abstract truncated at 2000 characters)
Izvleček		Zanimalo nas je preživetje 301 bolnikov, ki smo jih v našem centru operirali zaradi kronične ishemične mitralne insuficience (CIMR), v povezavi z aortokoronarnimi premostitvami (CABG) v obdobju med 1990 in 2002. Zgodnja umrljivost je bila 11,2% (34 bolnikov), pozna pa 20,5% (62 bolnikov). Uporabili smo tri različne kirurške tehnike: CABG brez posega na mitralni zaklopki (CABG - MI), N = 93, CABG z popravo mitralne zaklopke (CABG - PVM), N = 117 in CABG z zamenjavo mitralne zaklopke (CABG - MVR), N = 91. V skupini CABG - MI je bilo več bolnikov z dobro LVEF, v skupini CABG - PVM pa več bolnikov s slabo LVEF, v skupini CABG - MVR pa je bila razporeditev med slabo, srednje dobro in dobro LVEF skoraj enekovredna - rezultati so statistično pomembni (p = 0.0086). Prav tako je pomembna povezava med tipom operacije in zgodnjo umrljivostjo (p = 0.0124): CABG - MI = 3%, CABG - MVR = 15% in CABG - PVM = 15%. Povezava med uporabo LIMA in zgodnjo umrljivostjo je statistično mejno pomembna, v prid uporabe LIMA (p = 0.0513). Cox-ov proporcionalni model tveganja je pokazal povezavo med tipom operacije in uporabo LIMA, v odnosu na pozno umrljivost bolnilcov. Skupina CABG - MI je imela boljše dolgoročne rezultate, za razliko od skupin CABG - MVR in CABG - PVM, ki sta imeli značilno večje tveganje. Raven tveganja za CABG - MVR, v primerjavi s CABG MI, je 2.55 (pri 95% intervalu zaupanja) in 2.77, v primerjavi s CABG - PVM (pri 95% intervalu zaupanja). Skupina z uporabo LIMA ima statistično nižji nivo tveganja; nivo tveganja je 0.48% (pri 95% intervalu zaupanja). Zaključimo lahko, da rezultati kažejo, da je uporaba LIMA presadkov pomemben dejavnik dolgoročnega preživetja pri bolnikih s CIMR. (Izvleček skrajšan pri 2000 znakih)
Deskriptorji		MITRAL VALVE INSUFFICIENCY CORONARY ARTERY BYPASS HEART VALVE PROSTHESIS TREATMENT OUTCOME SURVIVAL ANALYSIS