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The Annals of Thoracic Surgery, Vol 47, 655-662, Copyright © 1989 by The Society of Thoracic Surgeons
AC Galloway, SB Colvin, FG Baumann, EA Grossi, GH Ribakove, S Harty and FC Spencer
The continued good results after mitral valve reconstruction prompted this
retrospective study to compare operative and late results from our
institutional experience since 1976 with 975 porcine mitral valve
replacements (MVRs) (1976 to December 1987), 169 mechanical MVRs (1976 to
December 1987), and 280 Carpentier-type mitral valve reconstructions (CVRs)
(1980 to mid-1988). The operative mortality was 2.0% for isolated CVR, 6.6%
for isolated mechanical MVR, and 8.5% for isolated porcine MVR. The overall
operative mortality was 5.0% for CVR, 16.6% for mechanical MVR, and 10.6%
for porcine MVR. The overall 5-year survival including hospital deaths was
76% for CVR, 72% for mechanical MVR, and 69% for porcine MVR. By
multivariate analysis, the predictors of increased operative risk and of
decreased survival were age, New York Heart Association functional class IV
status, previous cardiac operation, and performance of concomitant cardiac
surgical procedures. The type of valvular procedure was not predictive of
operative risk or overall survival. The 5-year freedom from reoperation was
94.4% for nonrheumatic patients having CVR, 77.4% for rheumatic patients
having CVR, 96.4% for mechanical MVR, and 96.6% for porcine MVR (p less
than 0.05, rheumatic patients with CVR versus both MVR groups). The 5-year
freedom from all valve-related morbidity and mortality was significantly
better for valve reconstruction compared with both types of valve
replacement. Thus, the operative risk and late survival obtained after
mitral valve reconstruction were at least equivalent to those obtained
after MVR. In addition, patients receiving mitral valve reconstruction had
less valve-related combined morbidity than patients receiving valve
replacement, thus making mitral valve reconstruction preferable in some
patients with mitral insufficiency.
ARTICLES
A comparison of mitral valve reconstruction with mitral valve replacement: intermediate-term results
Department of Surgery, New York University Medical Center, New York 10016.
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M. Enriquez-Sarano, H. V. Schaff, T. A. Orszulak, A. J. Tajik, K. R. Bailey, and R. L. Frye Valve Repair Improves the Outcome of Surgery for Mitral Regurgitation : A Multivariate Analysis Circulation, February 15, 1995; 91(4): 1022 - 1028. [Abstract] [Full Text]
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D. A. Ott Repairing the Mitral Valve Circulation, February 15, 1995; 91(4): 1264 - 1265. [Full Text]
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J. A. M. van Son, G. K. Danielson, H. V. Schaff, and F. A. Miller Jr. Traumatic tricuspid valve insufficiencyExperience in thirteen patients J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 893 - 898. [Abstract] [Full Text]
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T. Shimono, H. Yuasa, T. Mizumoto, K. Hatanaka, H. Kusagawa, and I. Yada New surgical method of chordal replacement for mitral valve incompetence with echocardiographic guidanceAn experimental study J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 719 - 726. [Abstract] [Full Text]
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L. H. Cohn, G. S. Couper, S. F. Aranki, R. J. Rizzo, N. M. Kinchla, and J. J. Collins Jr. Long-term results of mitral valve reconstruction for regurgitation of the myxomatous mitral valve J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 143 - 151. [Abstract] [Full Text]
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M.J. Antunes Mitral valve repair into the 1990s Eur. J. Cardiothorac. Surg., January 1, 1992; 6(suppl_1): S13 - S16. [Abstract] [PDF]
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