Document Detail

Determinants of survival and left ventricular performance after mitral valve replacement. Department of Veterans Affairs Cooperative Study on Valvular Heart Disease.
MedLine Citation:
PMID:  2317900     Owner:  NLM     Status:  MEDLINE    
To determine how survival and clinical status were related to left ventricular (LV) size and systolic function after mitral valve replacement, 104 patients (48 mitral regurgitation [MR], 33 mitral stenosis [MS], and 23 MS/MR) with isolated mitral valve replacement were evaluated before and after surgery. Preoperative hemodynamic abnormalities by cardiac catheterization were improved 6 months after surgery in all three patient groups. The patients with MR exhibited reductions in LV end-diastolic volume index (EDVI) (117 +/- 51 to 89 +/- 27 ml/m2, p less than 0.001) and ejection fraction (EF) (0.56 +/- 0.15 to 0.45 +/- 0.13, p less than 0.001); however, the ratio of forward stroke volume to end-diastolic volume increased (0.32 +/- 0.21 to 0.45 +/- 0.17, p less than 0.001) because of the elimination of regurgitant volume. Survival analysis revealed that mortality was significantly higher in MS or MS/MR patients with postoperative EDVI more than 101 ml/m2 (p less than 0.001 and p less than 0.042, respectively) and in MR patients with postoperative EF less than or equal to 0.50 (p less than 0.031). Also, the majority of patients with MR or MS/MR and postoperative EDVI more than 101 ml/m2 and EF less than or equal to 0.50 were in New York Heart Association class III or IV. Multivariate logistic regression analysis in the patients with MR revealed that the strongest predictor of postoperative EF was preoperative EF (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
M H Crawford; J Souchek; C A Oprian; D C Miller; S Rahimtoola; J C Giacomini; G Sethi; K E Hammermeister
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  81     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-05-02     Completed Date:  1990-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1173-81     Citation Subset:  AIM; IM    
Department of Medicine, University of New Mexico School of Medicine, Albuquerque 87131.
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MeSH Terms
Heart / physiopathology*
Heart Valve Prosthesis / mortality*
Heart Ventricles
Mitral Valve / radiography,  surgery*
Postoperative Period
Prospective Studies
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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