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. 2025 Feb 17;40(2):e20230294.
doi: 10.21470/1678-9741-2023-0294.

Rheumatic Mitral Valve Surgery: Repair or Replacement?

Luís Henrique Oliveira Pereira  1 , Kelvin Câmara  1 , Tamires Santos Pinheiro  1 , Matheus Mônaco Lemos  1 , Ana Laísa Andrada Oliveira  2 , Maria Eduarda Pereira de Oliveira  3 , Gabrielly Machado Trindade  4 , Manoel Flávio Silva Kanisky  1 , Marjorie Francisca Raksa  1 , Gerlanio César da Silva  1 , Valdano Manuel  5   6   7
Affiliations

Rheumatic Mitral Valve Surgery: Repair or Replacement?

Luís Henrique Oliveira Pereira et al. Braz J Cardiovasc Surg. .

Abstract

Introduction: Rheumatic heart disease remains a public health problem, especially in developing countries. The mitral valve (MV) is the main affected cardiac structure, requiring intervention in many cases. The discussion of which is the best option - repair or replacement - is still a controversy.

Objective: To compare the survival of patients with rheumatic MV submitted to replacement or repair.

Methods: We systematically reviewed the English literature through PubMed®, Literatura Latino-Americana e do Caribe em Ciências da Saúde (or LILACS), Scientific Electronic Library Online (or SciELO), and Google Scholar between January 2021 and February 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) methodology. Articles with a sample of at least 30 patients who underwent MV replacement or repair were included.

Results: Six studies including 2874 patients were analyzed. Most of the patients were female (2001; 69.6%) with a ratio of 2.3:1. The ages ranged from 11 to 66 years. The mean follow-up varied from six to 106 months. In the MV repair group, mortality was 2.5% (62 of 2473) and reoperation was 3.7% (93 of 2473), while in the MV replacement group, mortality was 8.2% (106 of 1291), and 3.6% (54 of 1475) of the patients required reoperation. The patient's survival was similar (85% for repair and 87% for replacement). The main complications post-MV repair or replacement were stroke (1.8%; 2.5%) and endocarditis (0.5%; 1.3%).

Conclusion: The MV repair had lower mortality and fewer complications compared to MV replacement. Reoperation rate and survival are similar.

Keywords: Mitral Valve; Reoperation; Review; Rheumatic Heart Disease; Treatment Outcome.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) flowchart. LILACS=Literatura Latino-Americana e do Caribe em Ciências da Saúde; SciELO=Scientific Electronic Library Online.
Fig. 2
Fig. 2
Distribution of the study population.
See this image and copyright information in PMC

References

    1. Kumar RK, Antunes MJ, Beaton A, Mirabel M, Nkomo VT, Okello E, et al. Contemporary diagnosis and management of rheumatic heart disease: implications for closing the gap: a scientific statement from the American heart association. Circulation. 2020;142(20):e337–57. doi: 10.1161/CIR.0000000000000921.. Erratum in: Circulation. 2021;143(23):e1025-6. doi:10.1161/CIR.0000000000000984. - DOI - PubMed
    1. Handbook on Prevention and Control of Rheumatic Fever and Rheumatic Heart Disease . Directorate General of Health Services Ministry of Health & Family Welfare Government of India. 2015.
    1. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med. 2017;377(8):713–722. doi: 10.1056/NEJMoa1603693.. - DOI - PubMed
    1. Leal MTBC, Passos LSA, Guarçoni FV, Aguiar JMS, Silva RBRD, Paula TMN, et al. Rheumatic heart disease in the modern era: recent developments and current challenges. Rev Soc Bras Med Trop. 2019;52:e20180041. doi: 10.1590/0037-8682-0041-2019.. - DOI - PubMed
    1. Zühlke L, Engel ME, Karthikeyan G, Rangarajan S, Mackie P, Cupido B, et al. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the global rheumatic heart disease registry (the REMEDY study) Eur Heart J. 2015;36(18):1115–22a. doi: 10.1093/eurheartj/ehu449.. - DOI - PMC - PubMed

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