Thromboembolic complications after surgical correction of mitral regurgitation incidence, predictors, and clinical implications.

摘要: Objectives We sought to define thromboembolic risk after surgery for mitral regurgitation (MR), particularly ischemic stroke (IS) compared with the general population. Background Guidelines recommend in asymptomatic patients MR, but IS risks are unknown. Methods In 1,344 (age 65 ± 12 years) consecutively operated MR (procedures: 897 valve repair [MRep] and 447 replacement: 231 mechanical replacement [MVRm], 216 biological [MVRb]), complications, (diagnosed by neurologists), during follow-up were assessed early ( Results Ischemic occurred 130 patients: 1.9 0.4% 2.7 0.5% at 30 days 180 days, respectively, 8.1 0.8% 5 years. found that rates lowest MRep versus MVRb MVRm (6.1 0.9% vs. 8 2.1%, 16.1 2.7% years, p 0.10 between procedures) moderate >30 (risk ratio 1.7 overall; 1.3 MRep; 0.98 MVRb; 4.8 MVRm). Beyond declined further was similar population (relative 1.2) 0.9). Bleeding (10-year 7 1%, 14 4%, 16 3%, respectively). Conclusions Thromboembolic complications a reason both concern encouragement. The of is notable early, irrespective procedure, long term it not greater than MVRb. Preference should be emphasized, trials aiming preventing conducted reduce hemorrhagic MR.