[Surgical treatment of mitral valve malformations--25 years of experience].
During a period of 25 years (1979-2004), 24060 operations with extracorporeal circulation were performed. Of them 9536 (39.6%) were valvular procedures and 763 were combined with coronary bypass grafting. 4315 pts were operated (45.3% of valvular operations) because of mitral valve disease 5559 mitral valves were corrected, including multivalvular and combined procedures. Initially, mitral surgeries were predominant, but currently aortic valves are operated two times more frequently. In 85.5% of cases mitral valve replacement was necessary (with prosthetic valve), but 803 pts underwent reconstructive surgery (445 commissurotomies and 358 valvo/annuloplasties, including 135 implantations of annuloplasty rings). Additionally, 421 DeVega tricuspid valve annuloplasties were performed, and 15 tricuspid rings were implanted. Because of infective endocarditis 182 mitral valves were corrected, including the replacement of 78 infected prostheses. The pts age varied between 10 and 85. In 1980 the mean age was 40, but currently it has increased to 55, and the pts with coronary artery disease are approximately 10 years older. The general mortality among pts with ECC was 4.2% in 2003, and after valvular procedures 4%. The mortality after mitral valve replacement diminished from 12% to 4.5-5%, and after reconstructions was two times lower. The mortality among pts with endocarditis was 11.8%. Several characteristic trends were observed: increase of the number of elder pts, decrease of mitral valve procedures in comparison with aortic ones, more common coincidence of coronary artery disease, better preoperative status of the pts, and decrease of the operative risk.
Klinika Chirurgii Serca, Naczyń i Transplantologii, Instytut Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków. mcpfitzn@cyf-kr.edu.pl
Roman
R
Pfitzner
Jerzy
J
Sadowski
Antoni
A
Dziatkowiak
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D004696:Endocarditis / Q000453:epidemiology / Q000401:mortality; D005112:Extracorporeal Circulation / Q000706:statistics & numerical data; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000002:abnormalities* / Q000601:surgery*; D011044:Poland / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D015996:Survival Rate; D055815:Young Adult