Comparison of recovery after mitral valve repair and replacement.
OBJECTIVE
We sought to examine the comparative improvement in health status after primary mitral valve repair versus replacement in patients with mitral valve regurgitation in a longitudinal setting.


METHODS
We prospectively followed 267 patients with mitral valve regurgitation who underwent primary mitral valve repair (n = 163) and replacement (n = 104) between January 2002 and January 2005. Health status was evaluated at baseline and 1, 3, and 12 months after surgery with the validated short-form 36 and analyzed using generalized estimating equations with adjustment for propensity scores.


RESULTS
Compared with patients undergoing mitral valve replacement, patients requiring valve repair were younger and more likely to be male. The probability of postsurgical readmission because of cardiac events was low and similar between the two treatment groups. New York Heart Association functional class was significantly improved after both procedures, with better improvement achieved by mitral valve repair (P < .01). For both treatment groups, scores for most of the short-form 36 domains were depressed at 1 month; however, after 3- and 12-month lags, dramatic improvements were achieved in most of the domains. Adjusted changes in the physical component score were similar between the two arms at each follow-up. For the mental component score, patients who underwent repair showed significant improvements compared with patients who underwent replacement at both 3 months (difference: 4.84 points, P = .005) and 12 months (difference: 5.92 points, P < .001).


CONCLUSIONS
Our study suggests that after mitral valve surgery, there is significant improvement in New York Heart Association functional class and health status, especially in patients undergoing mitral valve repair.
Zhao
Liping
L
Christiana Care Health System, Newark, Del 19713, USA. lzhao@christianacare.org
Kolm
Paul
P
Borger
Michael A
MA
Zhang
Zefeng
Z
Lewis
Cheryl
C
Anderson
Grant
G
Jurkovitz
Claudine T
CT
Borkon
A Michael
AM
Lyles
Robert H
RH
Weintraub
William S
WS
D005260:Female; D006304:Health Status; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires