[Extensive indication of mitral valvuloplasty for non-rheumatic mitral regurgitation and postoperative QOL].
Between January 1993 and June 1996, 108 patients with non-rheumatic mitral regurgitation (MR) underwent surgical treatment. Mitral valvuloplasty (MVP) was performed in 94 patients (87%) and mitral valve replacement (MVR) was performed in 14 patients. The patients were reviewed based on the location of the prolapse, active endocarditis, and re-valvuloplasty. The proportion of MVP patients to the total number of cases was 92%, 96% and 94% for prolapse of the anterior mitral leaflet (MVP: n = 22), the posterior mitral leaflet (n = 47) and of both leaflets (n = 15), respectively; it was 60% and 33% in the patients with active infective endocarditis (n = 3) and in reoperation cases (n = 3). Reoperation was required in 2 patients. Other than reoperation cases, 3/4 grade MR was detected by color Doppler echocardiography in 6 patients although they were asymptomatic. Thromboembolism occurred in 3 patients. The event-free rate at 42 months was 80.4%. Concomitant maze procedure was performed in 36 of 39 patients with atrial fibrillation and normal sinus rhythm was obtained in 25 of the 36 patients. Only 6 patients received warfarin anticoagulation after MVP. In current cases with non-rheumatic MR, the MVP could be performed in 87% of all patients and in 94% of the patients with simple prolapse, regardless of the prolapse area. Concomitant maze procedure might provide a better quality of life after MVP.
Nakano
K
K
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Eishi
K
K
Sasako
Y
Y
Kobayashi
J
J
Kosakai
Y
Y
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000534:rehabilitation / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000534:rehabilitation / Q000601:surgery*; D011788:Quality of Life