VALVE-RELATED EVENTS AND VALVE-RELATED MORTALITY IN 340 MITRAL-VALVE REPAIRS - A LATE-PHASE FOLLOW-UP-STUDY

To assess the early and late valve-related events, 340 consecutive pat ients undergoing mitral valve repair from 1969 to 1988 were evaluated. Follow-up was complete, with a mean of 7.5% years and range from 2 to 22 years (cumulative 2456 patient-years). There were 221 (65%) female patients. Rheumatic valvular disease was present in 246 (68%) patient s. The remaining patients had ischemic or congenital valve disease, fl oppy valve or infective endocarditis. At surgery, 47% of the patients had pure mitral incompetence, 43% had mixed mitral stenosis and incomp etence and 10% had predominant mitral stenosis. Seventy-three percent of the patients were in functional class III or IV. Twelve percent had had prior heart surgery. Concomitant valve procedures including coron ary revascularization were performed in 62.3%. There were 23 hospital deaths (6.8%) but only 3 of these (0.8%) were valve-related in patient s who died at reoperation for valve repair failure. There were 4 other early repair failures who survived early reoperation. Of the 317 hosp ital survivors, there were 127 late deaths, and an actuarial survival of 44 +/- 3.7% (70% CL) at 14 years. Of these, 13 were valve-related o r 0.5% patient-year. Late events included thromboembolism (TE) 1% pati ent-year, anticoagulant bleeding 0.4% patient-year, infective endocard itis (IE) 0.2% patient-year and late reoperation for mitral valve repa ir failure in 63 patients or 2.8% patient-year. At the late follow-up, 88% of the hospital survivors were in functional class I or II. The l ow incidence of both valve-related events and mortality reinforces our belief that mitral valve reconstructive procedures are durable and of fer a good alternative to mitral valve replacement.