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Clinical Guidelines in Mitral and Tricuspid Valve Surgery
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Clinical Guidelines in Mitral and Tricuspid Valve Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 4151

Special Issue Editors

Dr. Erez Sharoni

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Carmel Medical Center, Haifa 34361, Israel
Interests: cardiothoracic surgery; valve repair; beating heart surgery; surgical solutions for CHF
Dr. Dror B. Leviner

E-Mail Website
Guest Editor
Department of Cardiac Surgery, Carmel Medical Center, Haifa 34361, Israel
Interests: coronary artery bypass graft; aortic valve replacement; mitral valve replacement; mitral valve repair
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Clinical guidelines are written by an expert panel and used, as their name implies, to help guide the treatment of patients daily. The writing of guidelines requires a long process and as such, the guidelines can often be outdated on specific topics when they are published. Moreover, different societies (such as the American heart association and the European society of cardiology, together with the relevant surgical societies) often publish discrepant guidelines on the same topic, leading physicians to dilemmas in clinical decision making. In this Special Issue, we will touch on the guidelines in mitral and tricuspid valve surgery, hurdles to their implementation in different settings, differences between American and European guidelines and use of mechanical valves in the real world compared to the guidelines, attempting to anticipate future directions the guidelines may take with the possible use of new technological tools, such as artificial intelligence.  

Dr. Erez Sharoni
Dr. Dror B. Leviner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mitral valve repair
  • mitral valve replacement
  • tricuspid valve repair
  • tricuspid valve replacement

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Published Papers (3 papers)

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Research

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9 pages, 565 KiB  
Article
Minimally Invasive Mitral Valve Surgery in Elderly Patients: Results from a Multicenter Study
by Alessandra Francica, Cristina Barbero, Filippo Tonelli, Alfredo Giuseppe Cerillo, Vittoria Lodo, Paolo Centofanti, Giovanni Marchetto, Germano Di Credico, Ruggero De Paulis, Pierluigi Stefano, Giovanni Battista Luciani, Francesco Onorati and Mauro Rinaldi
J. Clin. Med. 2024, 13(21), 6320; https://doi.org/10.3390/jcm13216320 - 23 Oct 2024
Viewed by 1437
Abstract
Background: Minimally invasive mitral valve surgery (MIMVS) has been increasingly adopted worldwide as an alternative to conventional sternotomy, especially for young patients. The remarkable results gained by MIMVS have encouraged its application in more complex and fragile patients, such as the elderly, though [...] Read more.
Background: Minimally invasive mitral valve surgery (MIMVS) has been increasingly adopted worldwide as an alternative to conventional sternotomy, especially for young patients. The remarkable results gained by MIMVS have encouraged its application in more complex and fragile patients, such as the elderly, though results in this subgroup remain controversial. It is the aim of this study to assess the postoperative outcomes of patients older than 75 years old undergoing MIMVS, and to compare these results to those of younger patients. Methods: The data of all patients undergoing MIMVS between 2015 and 2022 were retrospectively collected at seven high-volume cardiac surgery centers. Patients were divided into two age-based groups: the young (<65 years old) and the elderly (>75 years old). A propensity score (PS) matching analysis obtained two comparable groups. Postoperative outcomes were assessed in both the unmatched and PS-matched populations. Results: Out of 1113 patients undergoing MIMVS, 524 were young and 279 were elderly. Elderly patients were more commonly affected by multiple comorbidities, with a higher EuroSCORE II (4.6 ± 5.5% vs. 1.6 ± 3.3%, p < 0.001). There was no difference in postoperative mortality, though the elderly had a greater incidence of postoperative complications, such as re-exploration for bleeding, stroke, reintubation, and a need for hemodialysis and blood transfusions. After PS matching, 119 pairs of young and elderly patients with similar risk profiles (EuroSCORE II 2.5 ± 4.7% vs. 2.7 ± 3.2%, p = 0.7) were compared, and no differences in all postoperative outcomes were found. Conclusions: Adequately selected elderly patients can report hospital outcomes similar to young patients after MIMVS. Full article
(This article belongs to the Special Issue Clinical Guidelines in Mitral and Tricuspid Valve Surgery)
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10 pages, 538 KiB  
Article
Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure
by Adrián Lozano Ibañez, Paloma Pulido, Javier López Díaz, María de Miguel, Gonzalo Cabezón, Andrea Oña, Pablo Zulet, Adrián Jerónimo, Daniel Gómez, Daniel Pinilla-García, Carmen Olmos, Carmen Sáez, Javier B. Pérez-Serrano, Isidre Vilacosta, Itziar Gómez-Salvador and J. Alberto San Román
J. Clin. Med. 2024, 13(20), 6222; https://doi.org/10.3390/jcm13206222 - 18 Oct 2024
Cited by 1 | Viewed by 929
Abstract
Background/Objectives: Heart failure worsens the prognosis of patients with infective endocarditis (IE) and is mainly caused by severe valvular regurgitation. The aim of our investigation is to describe the clinical, epidemiological, microbiological, and echocardiographic characteristics of patients with native left-sided infective endocarditis (NLSIE) [...] Read more.
Background/Objectives: Heart failure worsens the prognosis of patients with infective endocarditis (IE) and is mainly caused by severe valvular regurgitation. The aim of our investigation is to describe the clinical, epidemiological, microbiological, and echocardiographic characteristics of patients with native left-sided infective endocarditis (NLSIE) with severe valvular regurgitation; to describe the prognosis according to the therapeutic approach; and to determine the prognostic factors of in-hospital mortality. Methods: We prospectively recruited all episodes of possible or definite NLSIE diagnosed at three tertiary hospitals between 2005 and 2022. Patients were divided into two groups: patients with severe valvular regurgitation at the time of admission or during hospitalization and patients without severe valvular regurgitation. We analyzed up to 85 variables concerning epidemiological, clinical, analytical, microbiological, and echocardiographic data. Results: We recovered 874 patients with NLSIE, 564 (65%) of them with severe valvular regurgitation. There were no differences in mortality among patients with and without severe regurgitation (30.2% vs. 26.5%, p = 0.223). However, mortality increased when patients with severe regurgitation developed heart failure (33% vs. 11.4%, p < 0.001). Independent factors related to heart failure were age (OR 1.02 [1.01–1.034], p = 0.001), anemia (OR 1.2 [1.18–3.31], p = 0.01), atrial fibrillation (OR 2.3 [1.08–4.89], p = 0.03), S. viridans-related IE (OR 0.47 [0.3–0.73], p = 0.001), and mitroaortic severe regurgitation (OR 2.4 [1.15–5.02], p = 0.019). Conclusions: Severe valvular regurgitation is very frequent among patients with NLSIE, but it does not worsen the prognosis of patients unless complicated with heart failure. Full article
(This article belongs to the Special Issue Clinical Guidelines in Mitral and Tricuspid Valve Surgery)
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Review

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13 pages, 721 KiB  
Review
Glycated Haemoglobin (HbA1C) in Cardiac Surgery: A Narrative Review
by Suvitesh Luthra, Laura Viola, Manoraj Navaratnarajah, David Thirukumaran and Theodore Velissaris
J. Clin. Med. 2025, 14(1), 23; https://doi.org/10.3390/jcm14010023 - 24 Dec 2024
Viewed by 1273
Abstract
Background: Perioperative dysglycaemia in cardiac surgery is associated with poor outcomes. Glycaemic variability rather than glucose levels is a predictor of the length of an ICU stay, a rise in creatinine and acute kidney injury after cardiac surgery. Glycated haemoglobin (HbA1C) [...] Read more.
Background: Perioperative dysglycaemia in cardiac surgery is associated with poor outcomes. Glycaemic variability rather than glucose levels is a predictor of the length of an ICU stay, a rise in creatinine and acute kidney injury after cardiac surgery. Glycated haemoglobin (HbA1C) values correspond closely to average blood glucose levels and cut-off values can be used to define a diabetic and pre-diabetic status. These have been correlated with perioperative events. Methods: In this narrative review, MEDLINE (via PubMed) and the Cochrane Library were used to search for the effects of different preoperative HbA1C levels on the postoperative outcomes after cardiac surgery. HbA1C values correspond closely with average blood glucose levels and cut-off values can be used to define a diabetic and pre-diabetic status; these have been correlated with perioperative events. This narrative review discusses the role of HbA1C in cardiac surgery. Discussion: The scientific data show controversial results: some systematic reviews and randomised control trials demonstrated that a high level of HbA1C seems to be an indicator for postoperative complications in cardiac surgery; other studies dissented and reported that mortality and morbidity cannot be directly attributed to HbA1c levels. Conclusions: The scientific community seems to be in general agreement that high levels of HbA1C are prognostic markers of adverse outcomes post cardiac surgery, but it has also been proved that there could be multiple underlying factors contributing to them. Full article
(This article belongs to the Special Issue Clinical Guidelines in Mitral and Tricuspid Valve Surgery)
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