Árangur míturlokuviðgerða á Íslandi 2001-2012

• Main Authors: Jóhanna Fríða Guðmundsdóttir, Sigurður Ragnarsson, Arnar Geirsson, Ragnar Danielsen, Tómas Guðbjartsson
• Other Authors: Landspítali Hringbraut, Læknadeild Háskóli Íslands, Háskólasjúkrahúsið Skáni í Lundi Svíþjóð
• Format: Article in Journal/Newspaper
• Language: Icelandic
• Published: Læknafélag Íslands, Læknafélag Reykjavi­kur 2014
• Subjects: Hjartaaðgerðir; Female; Heart Valve Prosthesis; Heart Valve ProsthesisImplantation*/adverse effects; Treatment Outcome; Reoperation; Time Factors; Heart Valve ProsthesisImplantation*/instrumentation; Risk Factors; Risk Assessment; Prosthesis Design; Heart Valve Prosthesis Implantation*/mortality; Retrospective Studies; Humans; Iceland/epidemiology; Kaplan-Meier Estimate; Male; Middle Aged; Mitral Valve/surgery*; Mitral Valve Insufficiency/mortality; Mitral Valve Insufficiency/surgery*; Mitral Valve Stenosis/mortality; Mitral Valve Stenosis/surgery*; Postoperative Complications/etiology; Postoperative Complications/mortality; PostoperativComplications/surgery; Meier; Leka; Smella; Iceland
• Online Access: http://hdl.handle.net/2336/336501

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Vægur míturlokuleki er meðhöndlaður með lyfjum en við alvarlegan leka þarf að beita skurðaðgerð, en viðgerðir með hjartaþræðingartækni eru í örri þróun. Míturlokuviðgerðir hafa rutt sér til rúms í stað lokuskipta. Lokublöðin eru lagfærð og komið fyrir míturlokuhring. Rannsóknir hafa sýnt að snemmkominn árangur og langtímalifun eru umtalsvert betri eftir viðgerð en lokuskipti. --- Objectives: To review, for the first time, the outcome of mitral valve repair operations in Iceland. Material and methods: A retrospective study of all mitral valve repair patients (average age 64 yrs, 74% males) operated in Iceland 2001-2012. All 125 patients had mitral regurgitation; either due to degenerative disease (56%) or functional regurgitation (44%). Survival was estimated using the Kaplan-Meier method. The median follow-up time was 3.9 years Results: The number repair-procedures increased from 39 during the first half of the study period to 86 during the latter period. The mean EuroSCORE was 12.9% and 2/3 of the patients were in NYHA class III/IV. Half of them had severe mitral regurgitation, 12% had a recent myocardial infarction, and 10% a history of previous cardiac surgery. A ring annuloplasty was performed in 98% of cases, a posterior leaflet resection was done in 51 patients (41%), 28 received artificial chordae (Goretex®) and 7 an Alfieri-stitch. Concomitant cardiac surgery was performed in 83% of cases, where coronary artery bypass (53%), Maze-procedure (31%) or aortic valve replacement (19%) were most common. Major complications occurred in 56% of the cases and minor complications were noted in 71% of cases. Two patients later required mitral valve replacement. Eight patients died within 30 days (6%) and 5-year overall survival was 79%; or 84% and 74% for the degenerative and functional groups, respectively. Conclusions: The number of mitral valve repairs in Iceland increased significantly over the study period. Complications ...