FACTORS PREDICTIVE OF SURVIVAL AFTER MITR AL VALVULOPLASTY

Survival and freedom from reoperation following mitral valvuloplasty ( MV) was evaluated in 54 patients (pts) between October 1973 and Decemb er 1992. Ages of 35 men and 19 women averaged 49 years (+/- sd:18 yrs) . Preoperative NYHA class was II or III in 48 patients (89%) and class IV in 6 pts. At surgery, degenerative disease was present in 43 patie nts (80%), rheumatic in 8 pts (14%) and congenital in 3 pts (6%). Annu loplasty (Carpentier 18, Duran 27, others 3) was performed in 48 pts a nd was the sole procedure in 6 pts. Six pts underwent valvuloplasty wi thout annuloplasty. Associated procedures were performed in 18 patient s (33.3%). Operative mortality was 6% (3 pts). Follow-up ranged from 1 to 164 months with a mean of 39 mo. (+/- 5 mo.). Survival at 5 years was 89 +/- 8% and freedom from reoperation was 85 +/- 9%. NYHA status was significantly improved following mitral valvuloplasty (p < 0.00001 ). Operative complications and unfavorable post-operative NYHA status were significantly predictive of death (p < 0.05). Prior cardiac surge ry at the time of MV and post-operative unfavorable NYHA status were a ssociated with increased incidence of reintervention (p < 0.05). We co nclude that improved post-operative NYHA status heralds excellent long term survival and increased freedom from reoperation following mitral valve repair.