A prospective study of changes in the quality of life of patients following mitral valve repair and replacement

Objective: The primary aim of medical care and surgery for mitral valve dis ease is to improve the overall functional capacity and health of patients. Aim: To assess whether there was an actual improvement in quality of life ( QOL) of patients 3 months following primary mitral valve repair (MRr) or mi tral valve replacement (MVR). Methods: Prospective study of 61 consecutive patients (34 males, mean age 64 +/- 12) who underwent primary, isolated mit ral valve repair (MRr, n = 40) or mitral valve replacement (MVR, n = 21) fr om April 1997 to October 1998. QOL parameters using the validated short for m 36 (SF-36) questionnaire were determined before and at 3 months after sur gery and analysed using the Wilcoxon matched pairs rank test. Results: Mean QOL scores (scale 0-100) for all patients following mitral valve surgery s howed clinical and statistically significant improvement in seven of eight QOL parameters, namely (i) physical function (post, 60 +/- 31 vs. pre, 44 /- 29; P = 0.0001); (ii) role limitation due to physical function (50 +/- 4 2 vs. 23 +/- 36; P = 0.0002); (iii) social function (76 +/- 31 vs. 59 +/- 3 6; P = 0.0006); (iv) role limitation due to emotional problems (65 +/- 42 v s. 44 +/- 45; P = 0.003); (v) energy (57 +/- 24 vs. 40 +/- 24; P < 0.0001); (vi) mental health (73 +/- 20 vs. 66 +/- 21; P = 0.007); and (vii) general health perception (68 +/- 19 v 56 +/- 22; P = 0.0001); but not pain (73 +/ - 29 v 71 +/- 30; P = 0.4). Following MRr there was significant improvement in seven of eight QOL parameters and following MVR there was significant i mprovement in three of eight QOL parameters. Whilst patients with ejection fraction greater than or equal to 50% showed significant improvement in sev en of eight QOL parameters, there was no significant improvement in any QOL parameters in patients with impaired left ventricular (LV) function. Simil arly, patients with mitral regurgitation with end-systolic dimensions of : 45 mm showed no significant improvement in any QOL parameters at 3 months f ollow-up. Conclusions: Our study suggests that following mitral valve surge ry there was significant improvement in the QOL of patients especially in t hose patients requiring mitral valve repair. However, patients with impaire d LV function and those with MR with end-systolic dimensions : 45 mm were u nlikely to demonstrate a significant improvement in QOL at 3 months follow- up. (C) 2001 Elsevier Science B.V. All rights reserved.