Early and mid-term functional and survival benefits in ischaemic versus degenerative mitral valve repair using Duran flexible ring: a single surgeon series.
The late results of ischaemic mitral valve (MV) repair have been less than satisfying. We compared echocardiographically, the changes in LV function, mid-term durability and survival between MV repair caused by ischaemic cardiomyopathy (n=60) with degenerative MV disease (n=73) over a period of 15 years. The duration of mean follow-up was 3.7+/-4.1 years in the ischaemic group and 3.9+/-2.9 years in the degenerative group. Freedom from reoperation at seven years was 98.3%+/-1.5% and 98.9%+/-2.1%, respectively (P=0.889). At the last follow-up, NYHA functional class I or II was present in 78.4% of patients in the ischaemic group and 80.9% patients in the degenerative group (P=0.347). An improvement in LVEF was noted in both the groups: ischaemic--41.3+/-12.7 (pre-op LVEF: 38.8+/-14.1) and degenerative--46.5+/-11.1 (pre-op LVEF: 45.7+/-11.7) (P=0.014). At seven years, freedom from a cardiac cause of death was statistically similar in the two groups: 93.3%+/-1.3% and 92.2%+/-0.6% (P=0.967). In conclusion, the mid-term results of ischaemic MV repair are similar to those obtained for degenerative MV repair. Surgical correction of ischaemic MR results in long-term improved LVEF and comparable outcomes in terms of freedom from reoperation and survival.
Makhija
Zeena
Z
Department of Cardiothoracic Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK. profknow171@yahoo.com
Desai
Jatin
J
D001281:Atrial Fibrillation / Q000209:etiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D011474:Prosthesis Design; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left