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Thirty years experience with heart valve surgery: isolated mitral valve replacement
J R Bessell1, G Gower, D R Craddock
1Cardio-Thoracic Surgical Unit, Royal Adelaide Hospital, North Terrace, Australia.
The Australian and New Zealand Journal of Surgery
|December 1, 1996
Summary
This study evaluated 938 patients undergoing mitral valve replacement over 30 years. Pre-operative factors like atrial fibrillation and NYHA class impact long-term survival, guiding better patient selection for prosthetic mitral valve surgery.
Area of Science:
- Cardiovascular Surgery
- Medical Technology
- Patient Outcomes
Background:
- Open-heart surgery in South Australia commenced 30 years ago.
- A retrospective study was conducted to assess outcomes of mitral valve replacement.
- Evaluation of mortality and complication rates was performed.
Purpose of the Study:
- To evaluate mortality and complication rates in patients undergoing prosthetic mitral valve replacement.
- To identify factors associated with poor outcomes in these patients.
- To analyze long-term survival data for mitral valve recipients.
Main Methods:
- A database of 938 patients undergoing isolated prosthetic mitral valve replacement was compiled.
- Data included pre-operative, post-operative information, and long-term follow-up.
- Information was gathered via questionnaires and personal contact between 1963 and 1993.
Main Results:
- Hospital mortality rate was 4.7% over the 30-year period.
- Long-term survival was better for mitral stenosis patients but shorter for those with higher NYHA class or pre-operative atrial fibrillation.
- Pre-operative dyspnea improved post-surgery, with low rates of postoperative hemorrhage and embolism.
Conclusions:
- Mitral valve replacement recipients do not achieve normal life expectancy.
- Pre-operative identification of risk factors is crucial for appropriate patient selection.
- Risk factors can guide strategies to improve long-term survival in mitral valve recipients.