Valve-related events and valve-related mortality in 340 mitral valve repairs. A late phase follow-up study.
To assess the early and late valve-related events, 340 consecutive patients undergoing mitral valve repair from 1969 to 1988 were evaluated. Follow-up was complete, with a mean of 7.5% years and range from 2 to 22 years (cumulative 2456 patient-years). There were 221 (65%) female patients. Rheumatic valvular disease was present in 246 (68%) patients. The remaining patients had ischemic or congenital valve disease, floppy valve or infective endocarditis. At surgery, 47% of the patients had pure mitral incompetence, 43% had mixed mitral stenosis and incompetence and 10% had predominant mitral stenosis. Seventy-three percent of the patients were in functional class III or IV. Twelve percent had had prior heart surgery. Concomitant valve procedures including coronary revascularization were performed in 62.3%. There were 23 hospital deaths (6.8%) but only 3 of these (0.8%) were valve-related in patients who died at reoperation for valve repair failure. There were 4 other early repair failures who survived early reoperation. Of the 317 hospital survivors, there were 127 late deaths, and an actuarial survival of 44 +/- 3.7% (70% CL) at 14 years. Of these, 13 were valve-related or 0.5% patient-year. Late events included thromboembolism (TE) 1% patient-year, anticoagulant bleeding 0.4% patient-year, infective endocarditis (IE) 0.2% patient-year and late reoperation for mitral valve repair failure in 63 patients or 2.8% patient-year. At the late follow-up, 88% of the hospital survivors were in functional class I or II.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Thoracic and Cardiovascular Surgery, Deborah Heart and Lung Center, Browns Mills, NJ 08015.
J
J
Fernandez
D H
DH
Joyce
K J
KJ
Hirschfeld
C
C
Chen
S S
SS
Yang
G W
GW
Laub
M S
MS
Adkins
W A
WA
Anderson
J W
JW
Mackenzie
L B
LB
McGrath
D000206:Actuarial Analysis; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality* / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000401:mortality* / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000401:mortality* / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D012044:Regression Analysis; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors