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Ann Thorac Surg 2007;83:570-571
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Invited commentary

Kenton J. Zehr, MD

Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, UPMC/Presbyterian University Hospital, Suite C-700, 200 Lothrop St, Pittsburgh, PA 15213

(Email: zehrkj@upmc.edu).

The first 20% of the full text of this article appears below.

Feringa and colleagues [1] present a meta-analysis of 24 studies involving 470 patients undergoing mitral valve repair and 724 patients undergoing mitral valve replacement for endocarditis in the last decade. One of the strengths of the review is the fact that all patients were operated on after 1995, and thus after maturity of most mitral valve repair techniques. Virtually all early and late outcome variables assessed strongly support repairing the valve whenever possible.

Unfortunately, a retrospective review like this has many of the problems of outcome reporting for valvular surgery: (1) focus on the procedure performed regardless of the chronicity and presenting condition of the patient; (2) the bias of selective publication of high risk cohorts, and (3) the study of a large number of small, nonhomogenous cohorts. These problems often cause readers to dismiss a study in favor of their own anecdotally driven biases. I would urge that the article be read for the truth that is in it.

It is well accepted that patients undergoing mitral valve repair . . . [Full Text of this Article]


Related Article

Mitral Valve Repair and Replacement in Endocarditis: A Systematic Review of Literature
Harm H.H. Feringa, Leslee J. Shaw, Don Poldermans, Sanne Hoeks, Ernst E. van der Wall, Robert A.E. Dion, and Jeroen J. Bax
Ann. Thorac. Surg. 2007 83: 564-570. [Abstract] [Full Text] [PDF]





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