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Related Experiment Videos

Degenerative mitral regurgitation: when should we operate?

M J Dalrymple-Hay1, M Bryant, R A Jones

  • 1Wessex Cardiothoracic Centre, Southampton General Hospital, United Kingdom. MDH@btInternet.com

The Annals of Thoracic Surgery
|January 6, 1999
PubMed
Summary

Mitral valve repair offers superior survival outcomes compared to replacement for degenerative mitral valve disease. Early surgical intervention is recommended before significant cardiac damage occurs.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Medical Intervention Outcomes

Background:

  • Severe mitral regurgitation can cause irreversible cardiac damage in asymptomatic patients, often with little warning.
  • Surgical trends have shifted towards earlier intervention in less symptomatic patients with degenerative mitral valve disease.
  • This study reports on the experience with mitral valve operations between 1985 and 1996.

Purpose of the Study:

  • To compare the outcomes of mitral valve repair versus replacement in patients with degenerative mitral valve disease.
  • To evaluate the long-term survival and reoperation rates for mitral valve repair and replacement.
  • To identify factors associated with survival in patients undergoing mitral valve surgery.

Main Methods:

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  • A cohort of 710 patients with mitral regurgitation underwent operations from January 1985 to June 1996.
  • Focusing on 329 patients with degenerative mitral valve disease, 169 underwent repair and 160 underwent replacement.
  • Data collected included operative mortality, survival rates, reoperation rates, and associated clinical factors.

    • Main Results:

    • Overall operative mortality was 1.2%, with no deaths in the isolated mitral valve repair group.
    • Ten-year survival rates were significantly better for mitral valve repair (41%+/-5.8%) compared to replacement.
    • Factors associated with poorer survival included older age, worse left ventricular function, increased left ventricular size, and undergoing valve replacement.

    Conclusions:

    • Mitral valve repair demonstrates superior long-term survival compared to mitral valve replacement.
    • These findings support the recommendation for early mitral valve repair in patients with degenerative mitral valve disease.
    • Prompt surgical intervention before functional deterioration is crucial for optimal patient outcomes.