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[A ten years' experience with 613 mitral valve replacements].

Z J Geng

    Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
    |January 1, 1989
    PubMed
    Summary

    Early mitral valve replacement (MVR) is crucial to reduce mortality. Factors like emergency surgery and advanced heart conditions significantly increase early and late death risks after MVR.

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    Experience with 124 consecutive elective mitral valve replacements with a Shanghai-made tilting disc prosthesis.

    Chinese medical journal·1985
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    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Valve Disease
    • Surgical Outcomes Research

    Context:

    • Isolated mitral valve replacement (MVR) is a common cardiac procedure.
    • Understanding factors influencing mortality is vital for patient management.
    • This study analyzes outcomes in 613 patients undergoing MVR.

    Purpose:

    • To identify risk factors associated with early and late mortality after isolated mitral valve replacement.
    • To compare outcomes between mechanical tilting disc valves and porcine xenograft bioprostheses.
    • To provide recommendations for optimizing MVR surgical timing and postoperative care.

    Summary:

    • The study evaluated 613 patients undergoing isolated mitral valve replacement (MVR) between 1978 and 1987.
    • Early mortality was 4.89%, with emergency operations, biventricular hypertrophy, pulmonary hypertension, functional class IV, and reoperation identified as significant risk factors (P < 0.01).
    • Late mortality was higher in patients with mitral insufficiency, functional class IV, and left ventricular hypertrophy with strain (P < 0.01).

    Impact:

    • Recommends early MVR before significant comorbidities develop to improve surgical outcomes.
    • Suggests continued digitalis and/or diuretic therapy for 6-12 months postoperatively to enhance cardiac function.
    • Highlights a preference for mechanical valves due to bioprosthesis durability concerns.

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