title: [Long-term results of repair versus replacement for degenerative mitral valve regurgitation].
abstract: BACKGROUND
  Mitral valve repair is considered better than mitral valve replacement for degenerative mitral regurgitation.
  
  
  OBJECTIVE
  To evaluate late clinical results of mitral valve repair as compared to mitral valve replacement in patients with degenerative mitral regurgitation.
  
  
  METHODS
  All patients subjected to open heart surgery for degenerative mitral regurgitation between 1990 and 2002 were assessed for surgical mortality, late cardiac and overall mortality, reoperation, readmission to hospital, functional capacity and anticoagulant therapy. Eighty eight patients (48 males) had mitral valve repair and 28 (19 males) had mitral valve replacement (23 with a mechanical prosthesis). Mean age was 59.9 +/- 14.8 (SD) and 61.3 +/- 14.6 years, respectively. Sixty three percent of patients with repair and 50% of those with valve replacement were in functional class III or IV before surgery.
  
  
  RESULTS
  Operative mortality was 2.3% for mitral valve repair and 3.6% for mitral valve replacement (NS). Also, there was no statistical difference in the need of reoperation during the follow-up period between both procedures (2.3% and 0%, respectively). Ninety four percent of the replacement patients but only 26% of the repair patients were in anticoagulant therapy at the end of the follow-up period (p < 0.001). Ten years survival rates were 82 +/- 6% for mitral valve repair and 54 +/- 11% for replacement. The corresponding cardiac related survival rates were 89 +/- 6% and 79 +/- 10%. At the end of follow-up, all surviving patients were in functional class I or II. Ten years freedom from cardiac event rates (death, cardiac related rehospitalization and reoperation) were 90 +/- 3% for mitral valve repair and 84 +/- 6% for replacement.
  
  
  CONCLUSIONS
  Repair of the mitral valve offers a better overall survival and a better chance of freedom from cardiac events as well as need for anticoagulation 10 years after surgery.
authors.affiliation: Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquett
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Scheu
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Camplá
authors.forename: Sergio
authors.initials: S
authors.lastname: Morán
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Irarrázaval
authors.forename: Pedro
authors.initials: P
authors.lastname: Becker
authors.forename: Claudio
authors.initials: C
authors.lastname: Arretz
authors.forename: Samuel
authors.initials: S
authors.lastname: Córdova
authors.forename: Sandra
authors.initials: S
authors.lastname: Braun
authors.forename: Gastón
authors.initials: G
authors.lastname: Chamorro
authors.forename: Iván
authors.initials: I
authors.lastname: Godoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome