Results of Mitral Valve Repair in Rheumatic Mitral Lesions
Background: We compared results for repairs of rheumatic pure mitral regurgitation (MR) and mixed mitral stenosis (MS) and MR during early and midterm time intervals.
Methods: We retrospectively analyzed 173 patients (mean age 47.6 ± 15.1 years; 64 males) who underwent surgery for rheumatic heart disease during the period from January 1998 to June 2008. According to transvalvular mitral gradient, 91 patients had pure MR (group MR) and 82 (47%) had mixed MS-MR (group MS/MR). Preoperative and operative characteristics, postoperative MR severity, operative mortality, and early and midterm survival were examined for each surgical group.
Results: Preoperativley 153 patients (90.7%) were in New York Heart Association class III or IV. The most frequent pathology was leaflet prolapse (147 patients, 85.0%) and the most commonly performed procedure was annuloplasty (162 patients, 93.6%). Early mortality was similar for both groups (3.2% versus 1.2%; P = .621). The average duration of follow-up was 4.0 ± 2.4 years (a total of 679.1 patient years). Logistic regression analysis results indicated that subvalvular repairs were related to mortality. There were no significant differences in early mortality rate, valve-related morbidity, or reoperations.
Conclusion: Group MS/MR had more postoperative MR severity, and higher New York Heart Association class, but both groups had similar mortality and morbidity at the midterm survival point. Our results suggest that combined MS and MR repair can be performed as safely as pure MR.
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