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The Annals of Thoracic Surgery, Vol 56, 7-12, Copyright © 1993 by The Society of Thoracic Surgeons
TE David, S Armstrong, Z Sun and L Daniel
From June 1981 to August 1992, 184 patients with mitral regurgitation due
to degenerative disease underwent mitral valve repair. The mean age was 57
years, and 74% were men. One-third of the patients were in atrial
fibrillation, and 71% were in New York Heart Association classes III and
IV. The mitral regurgitation was due to prolapse of the posterior leaflet
in 97 patients (53%), prolapse of the anterior leaflet in 42 (23%), and
prolapse of both leaflets in 45 (24%). The degree of myxomatous changes was
assessed intraoperatively as mild in 125 patients (68%), moderate in 27
(15%), and severe in 32 (17%). Mitral valve repair was accomplished largely
by techniques described by Carpentier. Ring annuloplasty was performed in
160 patients (66 with Carpentier ring and 94 with Duran ring). There was
one operative death, and 5 patients experienced life-threatening
complications. Patients were followed up from 5 to 132 months (mean, 41
months). The actuarial survival at 8 years was 88% +/- 4%. The freedom from
stroke at 8 years was 94% +/- 2%, and the freedom from transient ischemic
attacks was 86% +/- 6%. Age greater than 60 years was the only factor
associated with higher risk of thromboembolic complications by logistic
regression analysis. The actuarial freedom from reoperation at 8 years was
95% +/- 2%. Advanced myxomatous changes in the leaflets of the mitral valve
was the only significant factor associated with a higher risk of
reoperation. Most patients were in New York Heart Association class I at
the last follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Late results of mitral valve repair for mitral regurgitation due to degenerative disease
Division of Cardiovascular Surgery, Toronto Hospital, Ontario, Canada.
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