Quality of life after mitral valve surgery: differences between reconstruction and replacement.
OBJECTIVE
Quality of life (QoL) is of increasing interest in major surgical procedures. Mitral valve reconstruction (MRr) is assumed to be better tolerated than mitral valve replacement (MVR). The study aim was to assess mid-term QoL in patients undergoing isolated mitral valve surgery.


METHODS
QoL was monitored in 115 consecutive patients who had isolated mitral valve surgery (62 with MVR, 53 with MRr). Mid-term survival was assessed after a mean of 37 +/- 18 months using the SF-36 health survey questionnaire.


RESULTS
Patients undergoing MVR were younger (61.9 +/- 12.7 versus 64.9 +/- 12.5 years; p <0.01) and had significantly more frequently a history of left heart failure (43.5% versus 13.2%; p <0.01) than patients with MRr. No significant difference was found between the two groups when considering preoperative NYHA functional class and left ventricular function. In-hospital mortality was significant higher in MVR than in MRr patients (6.4% versus 0%; p <0.01). QoL was significantly impaired in patients with MVR in physical function (PF), role function (RF) and general health (GH) compared with patients undergoing MRr. Nevertheless, only slight impairments in two of eight aspects in MVR, and in one of eight aspects in MRr, were found compared with an age- and sex-matched standard population. Mid-term survival was similar in both groups.


CONCLUSIONS
Outcome after MVR was excellent, though these patients had a more advanced stage of the disease preoperatively than MRr patients. Mid-term outcome and QoL was, however, similar in the two groups.
Immer
Franz E
FE
Department of Cardiovascular Surgery, University Hospital, Bern, Switzerland.
Donati
Olivio
O
Wyss
Thomas
T
Immer-Bansi
Alexsandra S
AS
Schmidli
Jürg
J
Berdat
Pascal A
PA
Carrel
Thierry P
TP
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000523:psychology; D002784:Cholesterol / Q000097:blood; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D019918:Heart Valve Prosthesis Implantation / Q000523:psychology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015994:Incidence; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery; D019990:Perioperative Care; D011788:Quality of Life / Q000523:psychology*; D013318:Stroke Volume / Q000502:physiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol