Document Detail

Mitral valve prolapse. Comparison between valvular repair and replacement in severe mitral regurgitation.
MedLine Citation:
PMID:  10221393     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to analyse long term results of mitral valve repair of degenerative mitral regurgitation compared to valve replacement. METHODS: A hundred-twenty-five consecutive patients with severe mitral valve insufficiency who underwent cardiac surgery from January 1987 to December 1995 were included in the study. Mean age was 55+/-16 years (77 males, 48 females). Mitral repair was performed in 62 patients and mitral valve was replaced in 63 patients. Mean follow-up was 5 years. The repair procedures were based on quadrangular resection of the posterior leaflet, chordal replacement and transposition. Annuloplasty was performed in 100% of cases. The technique of valve replacement was conventional with complete excision of the valve in the majority of cases. RESULTS: Operative mortality following valve repair was 1.6%, no death occurred in the prosthesic group. In the repair group overall survival and re-operation rate were respectively 95.2% and 6.5%, while in the replacement group were 93.7% and 7.9%. No endocarditis and thromboembolic accidents were observed following valvuloplasty, while in the prostheses 6.3% of patients had endocarditis and 1.6% had a thromboembolic event. Mild or moderate left ventricular dysfunction was present in 5 patients after valvuloplasty and in 9 patients with prostheses. CONCLUSIONS: Considering these results we conclude that, in patients with severe degenerative mitral insufficiency, mitral valve repair is warranted whenever it is possible. The advantages given by maintaining the native valve suggest that surgery should be considered in asymptomatic patients before the occurrence of the left ventricular dysfunction.
B Gramaglia; M Imazio; L Checco; M Villani; M Morea; M Di Summa; R Bonamini; E Rosettani; L Mangiardi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  40     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-05-13     Completed Date:  1999-05-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  93-9     Citation Subset:  IM    
University Cardiology Division, Molinette Hospital, Turin, Italy.
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MeSH Terms
Endocarditis, Bacterial / etiology
Heart Valve Prosthesis Implantation*
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / etiology,  mortality,  physiopathology,  surgery*
Mitral Valve Prolapse / complications,  physiopathology
Postoperative Complications
Retrospective Studies
Survival Rate
Treatment Outcome
Ventricular Function, Left
Comment In:
J Cardiovasc Surg (Torino). 2000 Jun;41(3):511   [PMID:  10952353 ]

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

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