[Predictive factors of survival after mitral valvuloplasty]

Survival and freedom from reoperation following mitral valvuloplasty (MV) was evaluated in 54 patients (pts) between October 1973 and December 1992. Ages of 35 men and 19 women averaged 49 years (+/- sd:18 yrs). Preoperative NYHA class was II or III in 48 patients (89%) and class IV in 6 pts. At surgery, degenerative disease was present in 43 patients (80%), rheumatic in 8 pts (14%) and congenital in 3 pts (6%). Annuloplasty (Carpentier 18, Duran 27, others 3) was performed in 48 pts and was the sole procedure in 6 pts. Six pts underwent valvuloplasty without annuloplasty. Associated procedures were performed in 18 patients (33.3%). Operative mortality was 6% (3 pts). Follow-up ranged from 1 to 164 months with a mean of 39 mo. (+/- 5 mo.). Survival at 5 years was 89 +/- 8% and freedom from reoperation was 85 +/- 9%. NYHA status was significantly improved following mitral valvuloplasty (p < 0.00001). Operative complications and unfavorable post-operative NYHA status were significantly predictive of death (p < 0.05). Prior cardiac surgery at the time of MV and post-operative unfavorable NYHA status were associated with increased incidence of reintervention (p < 0.05). We conclude that improved post-operative NYHA status heralds excellent long term survival and increased freedom from reoperation following mitral valve repair.