Evidence map›Paper›PMID 37840960›Full record

ArticleFrontiers in cardiovascular medicine2023

Effect of concurrent mitral valve surgery for secondary mitral regurgitation upon mortality after aortic valve replacement or coronary artery bypass surgery.

Shyamal R Asher, Chin Siang Ong, Raymond J Malapero, Mahyar Heydarpour, Gregory W Malzberg, Jasmine T Shahram, Thy B Nguyen, Douglas C Shook, Stanton K Shernan, Prem Shekar and 4 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in cardiovascular medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 2 countries.

Shyamal R AsherDepartment of Anesthesiology, Rhode Island Hospital, Providence, RI, United States.
Chin Siang OngDivision of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, United States.
Raymond J MalaperoDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Mahyar HeydarpourDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Gregory W MalzbergDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Jasmine T ShahramDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Thy B NguyenDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Douglas C ShookDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Stanton K ShernanDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Prem ShekarDivision of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States.
Tsuyoshi KanekoDivision of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States.
Rodolfo CitroCardio-Thoracic-Vascular Department, University Hospital-San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.
Jochen D MuehlschlegelDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Simon C BodyDepartment of Anesthesiology, Boston University School of Medicine, Boston, MA, United States.
Brigham and Women's Hospital · USBeth Israel Deaconess Medical Center · USBoston University · USMassachusetts General Hospital · USOspedali Riuniti San Giovanni di Dio e Ruggi d'Aragona · ITProvidence College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: It is uncertain whether concurrent mitral valve repair or replacement for moderate or greater secondary mitral regurgitation at the time of coronary artery bypass graft or aortic valve replacement surgery improves long-term survival. Methods: Patients undergoing coronary artery bypass graft and/or aortic valve replacement surgery with moderate or greater secondary mitral regurgitation were reviewed. The effect of concurrent mitral valve repair or replacement upon long-term mortality was assessed while accounting for patient and operative characteristics and mitral regurgitation severity. Results: Of 1,515 patients, 938 underwent coronary artery bypass graft or aortic valve replacement surgery alone and 577 underwent concurrent mitral valve repair or replacement. Concurrent mitral valve repair or replacement did not alter the risk of postoperative mortality for patients with moderate mitral regurgitation (hazard ratio = 0.93; 0.75-1.17) or more-than-moderate mitral regurgitation (hazard ratio = 1.09; 0.74-1.60) in multivariable regression. Patients with more-than-moderate mitral regurgitation undergoing coronary artery bypass graft-only surgery had a survival advantage from concurrent mitral valve repair or replacement in the first two postoperative years ( Conclusions: These observations suggest that mitral valve repair or replacement for more-than-moderate mitral regurgitation at the time of coronary artery bypass grafting may be reasonable in a suitably selected coronary artery bypass graft population but not for aortic valve replacement, with or without coronary artery bypass grafting. Our findings are supportive of 2021 European guidelines that severe secondary mitral regurgitation "should" or be "reasonabl[y]" intervened upon at the time of coronary artery bypass grafting but do not support 2020 American guidelines for performing mitral valve repair or replacement concurrent with aortic valve replacement, with or without coronary artery bypass grafting.

Indexed as

aortic valve surgerycoronary artery bypass surgeryguidelinesmitral regurgitationmitral valve surgerymortalityoutcomessurvival

Identifiers

PMID37840960
PMCPMC10570832
OpenAlexW4387213328

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.