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Predictors of prognosis in patients with mild to moderate paravalvular leakage after mitral valve replacement

 In-Jeong Cho  ;  Geu-Ru Hong  ;  Sak Lee  ;  Byung-Chul Chang  ;  Jong-Won Ha  ;  Namsik Chung 
 JOURNAL OF CARDIAC SURGERY, Vol.29(2) : 149-154, 2014 
Journal Title
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Edema ; Pioglitazone
BACKGROUND: The aim of this study was to evaluate predictors of clinical events in patients with mild to moderate paravalvular leakage (PVL) after mitral valve replacement (MVR). METHODS AND RESULTS: We retrospectively reviewed all the medical records and echocardiography of 60 patients with PVL after MVR. After excluding 18 patients who required immediate surgical repair for severe symptoms or regurgitation and four patients with severe anemia who required transfusion, two patients with concomitant infective endocarditis, two patients with severe stenosis or regurgitation of other valves, and one patient with severe left ventricular systolic dysfunction, the remaining 33 patients who were not indicated for reoperation or immediate blood transfusion comprised the study population. During a median follow-up period of 19 months, there were 18 events, including two cardiac deaths, one noncardiac death, 13 repeat surgeries, and two admissions for heart failure. Cox regression analysis revealed that the presence of hemolytic anemia at the diagnosis of PVL was the only independent predictor of event-free survival (p=0.035). The estimated three-year event-free survival rates were 78 ± 12% in patients without hemolytic anemia and 16 ± 10% in those with hemolytic anemia (p=0.004). CONCLUSION: Presence of hemolytic anemia was associated with poor short-term clinical outcome in mild to moderate PVL after MVR, even in the cases when the degree of anemia was not severe at the time of diagnosis. Therefore, in PVL patients after MVR with hemolytic anemia, more early aggressive therapeutic approaches should be considered, regardless of the severity of anemia.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Chang, Byung Chul(장병철)
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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