Long-Term Survival Comparison of Mitral Valve Repair and Mitral Valve Replacement in Rheumatic Mitral Valve Disease: A Propensity Score Analysis
Chaiwut Yottasurodom¹, Jayanton Patumanond²
Affiliation : ¹ Department of Cardiothoracic Surgery, Central Chest Institute of Thailand, Nonthaburi, Thailand; ² Clinical Epidemiology and Clinical Statistics Unit. Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
Objective: Rheumatic mitral valve disease could be treated either mitral valve repair or mitral valve replacement. The present study aimed to study 5-year survival related to mitral valve surgery using propensity score matching to reduce selection bias.
Materials and Methods: Between January 2007 and December 2013, 695 patients who underwent isolated mitral valve surgery were divided into two groups and matched with propensity score. Five-year survival was analyzed to assess outcomes following mitral valve repair and mitral valve replacement.
Results: Six hundred ninety-five patients were studied. After propensity matching, 267 patients in each group of mitral valve repair and mitral valve replacement, the groups had no differences in baseline characteristics. Log rank testing demonstrated no difference in unmatched group (p=0.49). After propensity-matched analysis, there was difference between 5-year survival of mitral valve repair at 89.8% (95% CI 84.9 to 93.2) and at 94.6% (95% CI 90.4 to 97.0) for mitral valve replacement with p=0.09 and hazard ratio 1.77 (95% CI 0.87 to 3.56, p=0.113).
Conclusion: The authors observed non-significant lower 5-year survival rates among patients with rheumatic mitral valve diseases who underwent mitral valve repair compared to replacement. Mitral valve repair in rheumatic heart disease should remain the main selection in experienced valve centers with high quality measures.
Received 2 January 2024 | Revised 17 April 2024 | Accepted 23 April 2024
DOI: 10.35755/jmedassocthai.2024.6.13994
Keywords : Rheumatic mitral valve disease; Mitral valve replacement; Mitral valve repair; Propensity score matching
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