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Long-term survival after isolated replacement of mitral valve with ball-valve prosthesis
Insights
Mitral valve replacement with a ball-valve prosthesis can prolong life for patients with moderate to severe symptoms. However, for those with mild symptoms or no cardiac issues, the benefits of surgery are uncertain.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Mitral valve disease significantly impacts patient prognosis.
- Ball-valve prostheses are a common surgical option for mitral valve replacement.
- Assessing the long-term survival benefits of mitral valve replacement is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the actuarial survival rates following mitral valve replacement using a ball-valve prosthesis.
- To determine the long-term efficacy of mitral valve replacement in patients with varying degrees of mitral valve disease severity and symptoms.
Main Methods:
- A cohort of 111 patients undergoing mitral valve replacement with a ball-valve prosthesis was followed.
- Actuarial survival rates were calculated, including hospital mortality.
- Follow-up extended to 8 years post-surgery.
Main Results:
- The overall hospital mortality was 10.8%.
- Actuarial survival rates were 66% at 5 years and 59% at 8 years.
- Survival benefits were more pronounced in patients with moderate to severe symptoms.
Conclusions:
- Mitral valve replacement with a ball-valve prosthesis offers a survival advantage for patients with moderate to severe mitral valve disease.
- The indication for mitral valve replacement in asymptomatic or mildly symptomatic patients with favorable prognosis requires careful consideration due to uncertain survival benefits.
Abstract:
In 111 patients whose diseases mitral valve was replaced with a ball-valve prosthesis the actuarial survival rate, including the hospital mortality of 10.8%, was 66% after 5 years and 59% after 8 years of follow-up. This suggests that in patients with moderate or severe symptoms due to mitral valve disease, replacing the valve can prolong life. However, in patients with no cardiac symptoms or with sinus rhythm and mild symptoms, it is doubtful that mitral valve replacement can prolong life, for the prognosis in these patients is favourable without operation.