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Long-term follow-up of mitral valve repair: a single-center experience

Ghada M M Shahin1, Geert J M G van der Heijden, Johannes C Kelder

  • 1Department of Cardio-thoracic Surgery and Cardiology, Sint Antonius Hospital Nieuwegein, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. g.m.m.shahin@isala.nl

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|July 1, 2006
PubMed

Insights

Long-term follow-up after mitral valve repair shows higher than expected mortality. Key predictors for death include coronary artery bypass grafting, kidney problems, older age, and reduced heart function.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Clinical Outcomes Research

Background:

  • Mitral valve regurgitation is a common condition requiring surgical intervention.
  • Long-term outcomes after mitral valve repair are crucial for patient management.
  • Assessing mortality determinants post-mitral valve repair is essential for improving survival rates.

Purpose of the Study:

  • To perform a long-term follow-up of patients undergoing mitral valve repair for regurgitation.
  • To identify independent predictors of mortality after this procedure.
  • To compare observed mortality rates with standardized mortality in the general population.

Main Methods:

  • Retrospective analysis of 119 patients operated between 1976 and 1981.
  • Exclusion of patients with prior mitral surgery, isolated stenosis, or congenital heart disease.
  • Kaplan-Meier survival analysis and multivariate analysis to identify mortality predictors, with up to 27 years of follow-up.

Main Results:

  • The 20-year overall mortality was 63%, significantly exceeding the standardized mortality rate of 30%.
  • Independent predictors for mortality included concomitant coronary artery bypass grafting, renal impairment, age over 60, and ejection fraction ≤40%.
  • Re-operation was necessary in 22.7% of cases.

Conclusions:

  • Mitral valve repair for regurgitation is associated with higher-than-expected long-term mortality.
  • Concomitant coronary artery bypass grafting, renal impairment, advanced age, and reduced left ventricular function are critical mortality predictors.
  • These findings highlight the need for careful patient selection and risk stratification.
Abstract

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