Midterm survival after decalcification of the mitral annulus

The aim of this study is to determine the midterm outcomes of patients who underwent decalcification and patch-reconstruction of the mitral annulus during mitral valve surgery in our department.

Between 1996 and 2004, a total of 81 consecutive patients with a mean age of 64 +/- 13 years underwent mitral valve surgery in the presence of extensive calcification of mitral annulus. In the majority of cases (n = 42, 52%), a mitral valve repair was performed after decalcification and patch-reconstruction of the mitral annulus. The remaining 39 patients (48%) received a mitral valve prosthesis (biological n = 20, mechanical n = 19). Retrospective analysis of preoperative, operative, and postoperative information of these 81 patients was performed. The follow-up period ranged between 4 and 10 years (mean follow-up, 5.8 +/- 3.1).

The 30-day mortality was 8.7% (n = 7). The actuarial survival rates at 5 years were 79% +/- 3%. At the latest follow-up, 34 patients (55.7%) were in New York Heart Association class I, 23 (37.7%) were in class II, and 4 (6.5%) were in class III. The freedom from reoperation at 5 years was 90.5% +/- 2%. There was only 1 stroke (1.6%), which occurred 1 year after the operation.

These results show that despite the increased perioperative risk and the difficult approach of the pathology in this patient group, decalcification and patch-reconstruction of the mitral annulus during mitral valve surgery can be performed safely with satisfactory and stable clinical midterm results.