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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

ZALAQUETT S, Ricardo et al. Twenty years of mitral valve repair. An experience in 322 patients. Rev. méd. Chile [online]. 2014, vol.142, n.9, pp.1089-1098. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872014000900001.

Background: Mitral valve repair is the preferred procedure for the surgical treatment of mitral valve insufficiency (MI), procedure that we initiated 20 years ago. Aim: To assess our experience and long-term results of mitral valve repair. Patients and Methods: The database of the cardiology department was reviewed for the period between December 1991 and December 2012. A total of 322 patients aged 18 to 89 years (62% males) undergoing mitral valve repair were identified. Long-term survival information was obtained consulting death certificate records of the Chilean Identification Service. The latest echocardiogram available was analyzed. Results: MI was degenerative in 144 patients (45%) and ischemic in 104 (32%). A prosthetic ring was used in all ischemic and in 92% of non-ischemic MI. Operative mortality was 7.5%, 13% in ischemic and 4.4% in non-ischemic MI (p < 0.01). Overall long-term survival was 14.1 years; 9.3 and 16 years for ischemic and non-ischemic MI, respectively (p < 0.001). Survival at 5, 10, 15 and 20 years was 79, 63, 54 and 42%, respectively. For degenerative MI survival at 5 and 10 years was 90 and 76% and for ischemic MI, it was 64 and 44%, respectively (p < 0.001). On a multivariate analysis the main predictors of late mortality were age, associated valvular disease and ischemic etiology. Echocardiographic follow-up was available for 223 patients; MI was absent in 53% and was mild in 29%. Conclusions: In a 20 years follow-up, mitral valve repair for MI had excellent long-term survival and echocardiographic results. The most common etiologies of MI were degenerative and ischemic diseases. The latter had a worst prognosis. The main predictors of long term mortality were age, associated valvular disease and ischemic etiology.

Keywords : Mitral valve; Mitral valve annuloplasty; Mitral valve insufficiency; Thoracic surgery.

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