[Clinical, functional and prognostic evaluation of ischemic mitral insufficienty surgical correction].
The aim of our study was to evaluate the patients' (pts) survival, changes of functional status after repair of ischemic mitral insufficiency (IMI) and to determine their prognostic determinants. Study group consisted of 128 pts who underwent mitral valve (MV) repair for IMI at Kaunas University of Medicine hospital during 1996 to 2002. Study protocol included general clinical data, coronary artery involvement, patients NYHA functional class, pre, post and operative echocardiographic data, mitral valve repair procedures.


RESULTS
There was a significant reduction of MR in all survivals from grade 2.8+/-0.1 to 1.5+/-0.1 (p<0.0001). All of the patients showed late postoperative increase in LVEF from 32.2+/-1.0 to 37.1+/-1.1% (p<0.0001). Late postoperative NYHA functional class changed significantly from 3.3+/-0.1 to 2.3+/-0.1 (p<0,0001). Two-year years survival without heart failure was 51.6+/-7.9%. Prognostic markers of late postoperative heart failure (II-IV NYHA functional class): LVEF</=24% and residual MR>/=II grade late postoperatively. Two-year years survival without residual MR was 51.1+/-7.8%. Predictors of late residual MR are early residual MR>I grade (p<0.0001), LVEF<30% early postoperatively (p<0.0001) and LVEDDI late postoperatively >/=28 mm/m(2) (p<0,01). Hospital mortality - 17.2%, late mortality - 7.9%. Two and four-year years survival after combined heart surgery - 66.7%.


CONCLUSIONS
Repair of IMI - effective method in treating ischemic heart disease complicated with MV regurgitation: late postoperatively patients functional status improves, LVEF increase. Prognostic markers of late postoperative heart failure (II-IV NYHA functional class) are: LVEF</=24% and residual MR>/=II grade late postoperatively.
Benetis
Rimantas
R
Clinic of Cardiac Surgery, Kaunas University of Medicine Hospital, Eiveniu 2, 3007 Kaunas, Lithuania.
Jankauskiene
Loreta
L
Ereminiene
Egle
E
Saferis
Viktoras
V
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D006333:Heart Failure / Q000175:diagnosis; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome