{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T21:47:39Z","timestamp":1780523259305,"version":"3.54.1"},"reference-count":25,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Unlike degenerative mitral valve (MV) disease, the advantages of valve repair procedure over replacement have been debated in rheumatic MV disease. This study aims to evaluate the impact of procedural types on long-term outcomes through analyses on a large data set from an endemic area of rheumatic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated 1731 consecutive patients (52.3\u00b112.5 years; 1190 women) undergoing MV surgery for rheumatic MV disease between 1997 and 2015. Long-term survival and valve-related outcomes were compared between repair and replacement procedures. To adjust for selection bias, propensity score analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients undergoing repair were younger and had more predominant mitral regurgitation than mechanical and bioprosthetic replacement groups (61.6% vs 15.6% vs 24.4%; P&lt;0.001). During follow-up (130.9\u00b127.7 months), 283 patients (16.3%) died and 256 patients (14.8%) experienced valve-related complications. Propensity score matching yielded 188 pairs of repair and replacement patients that were well balanced for baseline covariates. In the matched cohort, there was no significant difference in the mortality risk between the repair and replacement groups (HR, 1.24; 95% CI 0.62 to 2.48). The risk of composite valve-related complications, however, was significantly lower in repair group (HR, 0.57; 95%\u2009CI 0.33 to 0.99) principally derived by a lower risk of haemorrhagic events (HR, 0.23; 95%\u2009CI 0.07 to 0.70). The incidence of reoperation was not significantly different between groups in the matched cohort (HR, 1.62; 95%\u2009CI 0.49 to 5.28).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Valve repair in well-selected patients with severe rheumatic MV disease led to comparable survival, but superior valve-related outcomes compared with valve replacement surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/heartjnl-2017-312249","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T12:24:42Z","timestamp":1510835082000},"page":"841-848","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Clinical outcomes in 1731 patients undergoing mitral valve surgery for rheumatic valve disease"],"prefix":"10.1136","volume":"104","author":[{"given":"Wan Kee","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Bum","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Ho","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk Jung","family":"Choo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Hyun","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Won","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,11,16]]},"reference":[{"key":"2020050721401777000_104.10.841.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00558-4"},{"key":"2020050721401777000_104.10.841.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.03.091"},{"key":"2020050721401777000_104.10.841.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.08.058"},{"key":"2020050721401777000_104.10.841.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.11.019"},{"key":"2020050721401777000_104.10.841.5","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt093"},{"key":"2020050721401777000_104.10.841.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.12.002"},{"key":"2020050721401777000_104.10.841.7","first-page":"e521","article-title":"AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"2014","author":"Nishimura","year":"2014","journal-title":"Circulation"},{"key":"2020050721401777000_104.10.841.8","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj047"},{"key":"2020050721401777000_104.10.841.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00321-8"},{"key":"2020050721401777000_104.10.841.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.06.016"},{"key":"2020050721401777000_104.10.841.11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024769"},{"key":"2020050721401777000_104.10.841.12","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/S0140-6736(16)00547-X","article-title":"Valvular aspects of rheumatic heart disease","volume":"387","author":"Remenyi","year":"2016","journal-title":"Lancet"},{"key":"2020050721401777000_104.10.841.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31012-1"},{"key":"2020050721401777000_104.10.841.14","first-page":"1","article-title":"Rheumatic fever and rheumatic heart disease","volume":"923","author":"CHOP","year":"2004","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2020050721401777000_104.10.841.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70283-1"},{"key":"2020050721401777000_104.10.841.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70217-0"},{"key":"2020050721401777000_104.10.841.17","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2005.121590"},{"key":"2020050721401777000_104.10.841.18","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s11748-014-0459-x","article-title":"Controversy in mitral valve repair","volume":"62","author":"Sawazaki","year":"2014","journal-title":"resection or chordal replacement? Gen Thorac Cardiovasc Surg"},{"key":"2020050721401777000_104.10.841.19","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu365"},{"key":"2020050721401777000_104.10.841.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.03.009"},{"key":"2020050721401777000_104.10.841.21","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt012"},{"key":"2020050721401777000_104.10.841.22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s13019-016-0473-4","article-title":"Mid-term results of mitral valve palsty in patients with mitral sclerotic lesion","volume":"11","author":"Hirota","year":"2016","journal-title":"J Cardiothorac Surg"},{"key":"2020050721401777000_104.10.841.23","first-page":"868","article-title":"Knowledge base of clinicians regarding oral anticoagulant therapy in a teaching institution-a questionnaire survey","volume":"52","author":"Kakkar","year":"2004","journal-title":"J Assoc Physicians India"},{"key":"2020050721401777000_104.10.841.24","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.acvd.2015.12.004","article-title":"The VALVAFRIC study: a registry of rheumatic heart disease in Western and Central Africa","volume":"109","author":"Kingu\u00e9","year":"2016","journal-title":"Arch Cardiovasc Dis"},{"key":"2020050721401777000_104.10.841.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61171-9"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2017-312249","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T14:19:08Z","timestamp":1601043548000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2017-312249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,16]]},"references-count":25,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,4,26]]},"published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1136\/heartjnl-2017-312249"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2017-312249","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.732126028.793564329","asserted-by":"object"}]},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,16]]}}}