Our Summary

This study sought to understand the effects of two different heart treatments: mitral valve repair (MV-repair) and mitral valve replacement. It looked at patients who had a specific heart condition (severe mitral regurgitation) but whose hearts were otherwise functioning well and who didn’t have symptoms of heart failure.

The researchers looked at information from over 2000 patients who had one of these treatments in New York state hospitals between 2008 and 2014. They used a statistical method called propensity-matching to compare the death rates and other outcomes between the two groups of patients.

The results showed that the patients who had MV-repair had a significantly lower death rate after 4 years than those who had a valve replacement. The study also found that surgeons who performed more of these procedures were more likely to choose MV-repair.

In conclusion, for patients with this specific heart condition but no symptoms of heart failure, MV-repair seems to be a better option and lead to lower death rates. Therefore, the study suggests that surgeons should consider this option for these patients whenever possible.

FAQs

  1. What were the two heart treatments studied in this research?
  2. How did the death rates compare between patients who had mitral valve repair and those who had mitral valve replacement?
  3. Does the study suggest that surgeons should prefer mitral valve repair over replacement for patients with severe mitral regurgitation but no symptoms of heart failure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mitral valve repair is to discuss with their surgeon the benefits and risks of choosing MV-repair over mitral valve replacement, especially if they have severe mitral regurgitation but no symptoms of heart failure. Surgeons who have more experience with MV-repair may be more likely to recommend this option, which could potentially lead to better outcomes for the patient in the long run. It is important for patients to have open and honest communication with their healthcare team to make the best decision for their individual situation.

Suitable For

Patients who are typically recommended mitral valve repair are those with severe mitral regurgitation but whose hearts are otherwise functioning well and who do not have symptoms of heart failure. This study suggests that for these specific patients, mitral valve repair may lead to better outcomes and lower death rates compared to mitral valve replacement. Surgeons who perform more of these procedures are more likely to choose mitral valve repair, indicating that it is a preferred option for this patient population.

Timeline

Before Mitral Valve Repair:

  1. Patient is diagnosed with severe mitral regurgitation.
  2. Patient undergoes diagnostic tests such as echocardiogram to assess the severity of the condition.
  3. Patient may experience symptoms such as shortness of breath, fatigue, and palpitations.
  4. Surgeon recommends mitral valve repair as a treatment option.

After Mitral Valve Repair:

  1. Patient undergoes mitral valve repair surgery.
  2. Recovery period in the hospital, typically a few days to a week.
  3. Patient may need to participate in cardiac rehabilitation to regain strength and function.
  4. Follow-up appointments with the surgeon to monitor progress and assess the success of the procedure.
  5. Improvement in symptoms such as reduced shortness of breath and fatigue.
  6. Long-term monitoring to ensure the repaired valve continues to function properly.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve repair include:

  1. What is the specific procedure for mitral valve repair and how does it differ from mitral valve replacement?
  2. What are the potential risks and complications associated with mitral valve repair?
  3. How experienced are you in performing mitral valve repair procedures?
  4. Are there any alternative treatment options available for my condition?
  5. What is the expected recovery time and rehabilitation process after mitral valve repair?
  6. How likely is it that I will need additional procedures in the future after mitral valve repair?
  7. What lifestyle changes or restrictions will I need to follow after the procedure?
  8. How often will I need follow-up appointments and monitoring after mitral valve repair?
  9. What are the long-term outcomes and success rates for patients who undergo mitral valve repair?
  10. Are there any specific factors or considerations that make me a better candidate for mitral valve repair compared to mitral valve replacement?

Reference

Authors: Hannan EL, Samadashvili Z, Smith CR, Lahey SJ, Gold JP, Jordan D, Sundt TM 3rd, Girardi L, Ashraf MH, Chikwe J. Journal: J Thorac Cardiovasc Surg. 2019 Apr;157(4):1432-1439.e2. doi: 10.1016/j.jtcvs.2018.08.091. Epub 2018 Sep 26. PMID: 30482532