[A ten years' experience with 613 mitral valve replacements].
This study was performed to assess the effect of factors on early and late mortality of isolated MVR in 613 patients. The tilting disc valve was used in 480 and the porcine xenograft bioprosthesis in 133 patients between Sep. 1978 and Nov. 1987. The overall early mortality rate was 4.89%. A comparative analysis showed that five factors (emergency operation, biventricular hypertrophy with serain, pulmonary hypertension, function class IV, and reoperation) significantly increased the early mortality rates (P less than 0.01). A 10-year follow-up study showed that the late mortality rate was significantly higher in patients with mitral insufficiency, function class IV and left ventricular hypertrophy with strain (P less than 0.01). The authors emphasize that the MVR must be performed early before the factors affecting the operative outcome are fully developed. Successive treatment with digitalis and/or diuretics should be continued in early postoperative period for 6-12 months to improve the cardiac function. Owing to the well-known durability of the bioprosthesis the authors prefer the use of mechanical valve.
Z J
ZJ
Geng
D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000601:surgery