Long-term results of repair versus replacement for degenerative mitral valve regurgitation
Loading...
Date
2005
Journal Title
Journal ISSN
Volume Title
Publisher
SOC MEDICA SANTIAGO
Abstract
Background- Mitral valve repair is considered better than mitral valve replacement for degenerative mitral regurgitation. Aim To evaluate late clinical results of;mitral valve repair as compared to mitral valve replacement in patients with degenerative mitral regurgitation. Patients and methods: All patients subjected to open heart surgery for degenerative mitral regurgitation between 1990 and 2002 were assessed for surgical mortality late cardiac and overall mortality, reoperation, readmission to hospital, functional capacity and anticoagulant therapy. Eighty eight patients (48 males) bad mitral valve repair and 28 (79 males) bad mitral valve replacement (23 with a mechanical prosthesis). Mean age was 59.9 +/- 14.8 (SD) and 61.3 +/- 14.6 years, respectively. Sixty three percent of patients with repair and 50% of those with, valve replacement were in functional class III or IV before surgery. Results: Operative mortality was 2.3% for mitral valve repair and 3.6% for mitral valve replacement (NS). Also, there was no statistical difference in the need of reoperation during the follow-up period between both procedures (2.3% and 0%, respectively). Ninety four percent of the replacement patients but only 269,6 of the repair patients were in anticoagulant tberapy at the end of the follow-up period (p < 0.001). Ten years survival rates were 82 +/- 6% for mitral valve repair and 54 +/- 1.1% for replacement. The corresponding cardiac related survival rates were 89 +/- 6% and 79 +/- 10%. At the end of follow-up, all surviving patients were in functional class I or II. Ten years freedom from cardiac event rates (death, cardiac related rehospitalization and reoperation) were 90 +/- 3% for mitral valve repair and 84 +/- 6% for replacement. Conclusion: Repair of the mitral valve offers a better overall survival and a better chance of freedom from cardiac events as well as need for anticoagulation 10 years after surgery (Rev Med Chile 2005; 133: 1139-46).
Description
Keywords
mitral valve, mitral valve insufficiency, thoracic surgery, INSUFFICIENCY, SURGERY, RECONSTRUCTION, MANAGEMENT