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Rheumatic mitral valve surgery in the fifth decade: our experience
K S Rathore1, P Kumar, U Jadhav
1Department of Cardiovascular and Thoracic Surgery, Lokmanya Tilak Medical College and Hospital, Sion, Mumbai, India. kaushalendra_rathore @hotmail.com
The Journal of Cardiovascular Surgery
|January 24, 2008
Summary
Older rheumatic mitral patients are surviving longer. This study found improved outcomes for patients over 50 undergoing valve replacement, though age and other factors remain key risks.
Area of Science:
- Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Rheumatic heart disease increasingly affects patients into their fifth decade.
- Improved life expectancy necessitates better management of rheumatic mitral valve disease in older adults.
Purpose of the Study:
- To offer insights into reducing morbidity and mortality in rheumatic mitral patients aged 50 and above.
- To evaluate outcomes of mechanical versus bioprosthetic valve replacement in this demographic.
Main Methods:
- Retrospective analysis of 105 patients (≥50 years) undergoing valve replacement.
- Comparison of mechanical (n=75) and bioprosthetic (n=30) valve groups.
- Follow-up using echocardiography, clinical data, and X-rays.
Main Results:
- Perioperative mortality was 4.76%, with a 3% long-term mortality rate.
- Multivariate analysis identified age, repeat surgery, atrial fibrillation, tricuspid valve disease, and functional status as risk factors.
- Freedom from reoperation at 6 years was 85%; actuarial survival at 6 years was 88.52%.
Conclusions:
- Rheumatic valvular disease is increasingly seen in patients over 50.
- Valve replacement shows marked improvement in this group, but age remains a significant risk factor.
- Atrial fibrillation, repeat surgery, stroke, and tricuspid valve disease also impact outcomes.
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