Long-term results of mitral valve surgery for degenerative anterior leaflet or bileaflet prolapse: analysis of negative factors for repair, early and late failures, and survival†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Gonçalo F CoutinhoM J Antunes

Abstract

To evaluate the feasibility of mitral valve repair in patients with anterior leaflet (ALP) or bileaflet prolapse (BLP) and identify factors predisposing patients to replacement. To compare long-term survival of patients submitted to repair (Group Repair) against those submitted to replacement (Group Replacement), and investigate causes of early and late failures of repair. From January 1992 through December 2012, 768 patients with ALP or BLP were submitted to mitral valve surgery, of whom 501 had degenerative involvement [Myxomatous (Myx)-336 (67.1%) or fibroelastic deficiency (Fed)-165 (32.9%)] and constituted the study population. Isolated ALP was present in 274 patients (54.7%) and BLP in 227 (45.3%). Associated procedures were admitted. Patients with Fed were significantly older (64.4 ± 12.1 vs 54.8 ± 15.5 years, P < 0.001), more symptomatic (63 vs 44.3%; P < 0.001) and with higher incidence of atrial fibrillation (43.6 vs 26.2%; P < 0.001). Repair was achieved in 94.8% of patients with an overall 30-day mortality rate of 1.2% (0.3% in the last decade) and no differences regarding aetiology. Age, moderate to severe left ventricular (LV) dysfunction, previous cardiac surgery, multiple segment prolapse, mitral calcification, ...Continue Reading

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Citations

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European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Gonçalo F CoutinhoM J Antunes
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Gonçalo F CoutinhoM J Antunes
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Gonçalo F CoutinhoM J Antunes
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