title: Predictors of outcome of non-ischemic mitral valve surgery.
abstract: BACKGROUND
  Data on the risk stratification of patients undergoing mitral valve (MV) surgery for non-ischemic mitral disease are sparse. The present study seeks to define them in a contemporary cohort.
  
  
  METHODS
  193 consecutive patients referred to non-ischemic MV surgery were prospectively studied. Baseline characteristics and the type of surgery were analyzed with regard to operative and late mortality as well as functional outcome.
  
  
  RESULTS
  129 patients underwent MV replacement and 64 MV repair. MV replacement patients presented with more symptoms (p = 0.010), higher EuroSCORE (6.1 versus 5.6; p=0.009), more frequently underwent additional valve surgery (7.8 versus 0%; p = 0.003) and were more frequently female (p=0.048). Operative mortality was 3.1%, two thirds of operative deaths had additional surgery of the tricuspid valve (p = 0.019). Patients were followed for 5.2 ± 2.7 years. 1-, 3-, 5- and 7-year survival rates were 93-, 91-, 82-, and 79% in MV replacement patients versus 100-, 98-, 96-, and 89% in patients with MV repair (p = 0.015). However, by multivariate logistic regression, overall mortality was determined by additional surgery of the tricuspid valve (p = 0.0103), multivessel coronary disease (p = 0.026), and age (p<0.0001), but not by the type of surgery (p=0.066). Furthermore, the type of surgery did not influence functional outcome (p = 0.515).
  
  
  CONCLUSIONS
  Apart from age and coronary artery disease the need for additional tricuspid valve surgery significantly determines the outcome of non-ischemic MV surgery. The type of operation appears less important when the need for additional valve surgery and co-morbidities like coronary artery disease are taken into consideration.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria. julia.mascherbauer@meduniwien.ac.at
authors.forename: Julia
authors.initials: J
authors.lastname: Mascherbauer
authors.forename: Christina
authors.initials: C
authors.lastname: Fuchs
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pernicka
authors.forename: Gregor
authors.initials: G
authors.lastname: Wollenek
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosenhek
authors.forename: Diana
authors.initials: D
authors.lastname: Bonderman
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Helmut
authors.initials: H
authors.lastname: Baumgartner
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome