title: Single-centre experience with mitral valve repair in asymptomatic patients with severe mitral valve regurgitation.
abstract: OBJECTIVE
  Guidelines recommend surgical mitral valve repair in selected patients with asymptomatic severe mitral valve regurgitation (MR), but the role of repair remains a matter of debate. Survival analyses of operated asymptomatic patients have been reported, but long-term haemodynamics and quality of life are not well defined. The aim of this study was to report the long-term follow-up focusing on these aspects.
  
  
  METHODS
  Our database identified patients who underwent primary isolated mitral valve repair for severe MR and were asymptomatic by New York Heart Association Class I and in sinus rhythm. To obtain sufficient length of follow-up, only patients operated on before 2006 returned for an echocardiogram and quality-of-life assessment (SF-36).
  
  
  RESULTS
  Between May 1991 and December 2005, 46 asymptomatic patients with severe MR and a normal left ventricular function (ejection fraction >60%) were operated on. Mean age was 50.2 ± 13.2 years and 89% of patients were male. There were no operative deaths. Mean follow-up was 8.4 ± 3.9 years with 386 patient-years, survival was 93.3% at 12 years and comparable with the general age-matched Dutch population. Follow-up echocardiography showed that 92% had no to mild MR, and 3 patients had moderate MR. Left ventricular function was good/impaired/moderate in 66/29/5% of patients. Quality-of-life SF-36 assessment showed that mean physical and mental health components were 83 ± 17 and 79 ± 17, which was comparable with that of the general age- and gender-matched Dutch population.
  
  
  CONCLUSIONS
  Our experience shows that mitral valve repair for severe MR in asymptomatic patients is safe, and has satisfactory long-term survival with a low recurrence rate of MR, good left ventricular function, and excellent quality of life that is comparable with the general Dutch population.
authors: Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands. w.vanleeuwen.1@erasmusmc.nl
authors: Wouter J
authors: WJ
authors: van Leeuwen
authors: Stuart J
authors: SJ
authors: Head
authors: Lotte E
authors: LE
authors: de Groot-de Laat
authors: Marcel L
authors: ML
authors: Geleijnse
authors: Ad J J C
authors: AJ
authors: Bogers
authors: Lex A
authors: LA
authors: Van Herwerden
authors: A Pieter
authors: AP
authors: Kappetein
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D009426:Netherlands; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Asymptomatic; Haemodynamics; Mitral valve regurgitation; Mitral valve repair; Quality of life; Surgery; Survival