Outcomes of Mitral Valve Repair for Degenerative Mitral Disease: A Single-Centre 10-Year Experience
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Published on: October 16, 2021
Kemin Liu1, Qing Ye1, Yichen Zhao1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
Mitral valve repair for degenerative disease offers excellent long-term survival and low re-operation rates. Key risk factors for death include advanced age and low ejection fraction, while recurrent mitral regurgitation is linked to age, sex, and specific valve characteristics.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Degenerative Mitral Valve Disease
Background:
- Degenerative mitral valve (MV) disease is a significant cause of mitral regurgitation (MR).
- MV repair is a preferred surgical option, but long-term outcomes require evaluation.
Purpose of the Study:
- To assess the long-term efficacy and safety of MV repair in patients with degenerative MV disease.
- To identify risk factors associated with all-cause mortality and recurrent MR after MV repair.
Main Methods:
- Analysis of 1,069 patients undergoing MV repair for degenerative MV disease from 2010-2019.
- Clinical follow-up averaged 4.7 years, assessing perioperative complications, mortality, and long-term outcomes.
- Statistical analysis identified risk factors for all-cause death and recurrent MR.
Main Results:
- Long-term survival rate was 94.0%, with a low re-operation rate of 98.2%.
- Recurrent MR occurred in 11.2% of patients.
- Risk factors for death included advanced age and ejection fraction <60%; recurrent MR risk factors included age, female sex, anterior prolapse, and residual MR.
Conclusions:
- MV repair is effective for degenerative MV disease, demonstrating low mortality, recurrence, and re-operation rates in experienced centers.
- Advanced age and reduced ejection fraction are significant predictors of long-term mortality.
- Patient age, sex, specific echocardiographic findings, and residual postoperative MR predict recurrent mitral regurgitation.
Objective:
To evaluate the long-term outcomes of degenerative mitral valve (MV) repair.
Methods:
This study analysed 1,069 patients who underwent MV repair due to degenerative MV disease at Beijing Anzhen Hospital from January 2010 to December 2019. All patients were clinically followed until December 2019, with an average follow-up period of 4.7 years. Perioperative complications, 30-day mortality, long-term outcomes, and risk factors of all-cause death and recurrent mitral regurgitation (MR) were summarised.
Results:
Ten patients died in the hospital and 33 died during the follow-up period. Recurrent MR occurred in 113 patients. Fourteen patients underwent re-operation. Rates of long-term survival, absence of recurrent MR, and no re-operation were 94.0% (91.6%-96.6%), 81.2% (77.3%-85.3%), and 98.2% (97.2%-99.3%), respectively. The risk factors for long-term all-cause death included age and an ejection fraction (EF) <60%. The risk factors for recurrent MR included age, female sex, E-wave velocity, anterior prolapse, residual 1+MR postoperatively, and lower body mass index.
Conclusions:
Mitral valve repair is an effective treatment for degenerative MV disease that, in an experienced heart centre, can be performed with low mortality, recurrence, and re-operation rates. Advanced age and an EF <60% were risk factors for long-term all-cause death. Age, female sex, residual 1+MR postoperatively, lower body mass index, higher peak E-wave velocity, and anterior prolapse were risk factors for recurrent MR.
