TRANSSEPTAL APPROACH VERSUS LEFT ATRIAL APPROACH TO MITRAL VALVE: A PROPENSITY SCORE MATCHING STUDY

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REZAHOSSEINI OMID; REZAEI MOHAMADREZA; AHMADI TAFTI SEYED HOSSEIN; JALALI ARASH; BINA PAYVAND; GHIASI ATEFEH; KARIMI ABBASALI; ABBASI KIOMARS; SHIRZAD MAHMOOD; DAVOODI SAEED; SALEHI OMRAN ABBAS

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Journal: THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER Year:2015 | Volume:10 | Issue:4 Page(s): 188-193

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Title

TRANSSEPTAL APPROACH VERSUS LEFT ATRIAL APPROACH TO MITRAL VALVE: A PROPENSITY SCORE MATCHING STUDY

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Keywords

MITRAL VALVE

HEART SEPTUM

HEART ATRIA

ATRIAL FIBRILLATION

Abstract

Background: Many patients with MITRAL VALVE diseases need surgical procedures for the repair or replacement of their MITRAL VALVE. There is a great deal of controversy over the outcomes of the transseptal (TS) and left atrial (LA) approaches to the MITRAL VALVE. We sought to evaluate the outcomes of each approach more accurately by eliminating the possible biases in case selection and matching.Methods: This retrospective study included patients who had surgery for MITRAL VALVE diseases via either the TS approach or the LA approach between 2004 and 2011 in Tehran Heart Center. Patients with surgical approaches other than the TS and LA were excluded. To control for the confounding effects, a propensity score matching technique was applied and the patients were matched for 14 demographic and preoperative variables. After the selection of controls, the effect of the TS approach (163 patients) versus the LA approach (652 patients) on the outcomes was presented through odds ratio (OR) with 95% confidence intervals (CI).Results: The mean age of the patients was 53.15 ± 12.02 years in the TS group and 52.93 ± 13.56 years in the LA group. Females comprised 119 (73.0%) patients in the TS group and 462 (70.9%) in the LA group. There was a significant association in the prevalence of new postoperative ATRIAL FIBRILLATION in the two groups (OR=1.539, 95%CI: 1.072-2.210; p value=0.019). Temporary pacemaker placement had no statistically significant difference between the two groups (p value =0.418). The TS patients had significantly longer pump (p value<0.001) and cross-clamp (p value<0.001) times. The mortality rate was 4.1% (27 patients) in the LA group and 6.1% (10 patients) in the TS group (p value=0.274).Conclusion: In our study population, the TS approach was associated with higher pump and cross-clamp times as well as risk of postoperative ATRIAL FIBRILLATION, but it did not increase the rates of permanent pacemaker placement, re-operations, and mortality.

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APA: Copy

REZAHOSSEINI, OMID, REZAEI, MOHAMADREZA, AHMADI TAFTI, SEYED HOSSEIN, JALALI, ARASH, BINA, PAYVAND, GHIASI, ATEFEH, KARIMI, ABBASALI, ABBASI, KIOMARS, SHIRZAD, MAHMOOD, DAVOODI, SAEED, & SALEHI OMRAN, ABBAS. (2015). TRANSSEPTAL APPROACH VERSUS LEFT ATRIAL APPROACH TO MITRAL VALVE: A PROPENSITY SCORE MATCHING STUDY. THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER, 10(4), 188-193. SID. https://sid.ir/paper/302049/en

Vancouver: Copy

REZAHOSSEINI OMID, REZAEI MOHAMADREZA, AHMADI TAFTI SEYED HOSSEIN, JALALI ARASH, BINA PAYVAND, GHIASI ATEFEH, KARIMI ABBASALI, ABBASI KIOMARS, SHIRZAD MAHMOOD, DAVOODI SAEED, SALEHI OMRAN ABBAS. TRANSSEPTAL APPROACH VERSUS LEFT ATRIAL APPROACH TO MITRAL VALVE: A PROPENSITY SCORE MATCHING STUDY. THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER[Internet]. 2015;10(4):188-193. Available from: https://sid.ir/paper/302049/en

IEEE: Copy

OMID REZAHOSSEINI, MOHAMADREZA REZAEI, SEYED HOSSEIN AHMADI TAFTI, ARASH JALALI, PAYVAND BINA, ATEFEH GHIASI, ABBASALI KARIMI, KIOMARS ABBASI, MAHMOOD SHIRZAD, SAEED DAVOODI, and ABBAS SALEHI OMRAN, “TRANSSEPTAL APPROACH VERSUS LEFT ATRIAL APPROACH TO MITRAL VALVE: A PROPENSITY SCORE MATCHING STUDY,” THE JOURNAL OF TEHRAN UNIVERSITY HEART CENTER, vol. 10, no. 4, pp. 188–193, 2015, [Online]. Available: https://sid.ir/paper/302049/en

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