PMID- 12457312
OWN - NLM
STAT- MEDLINE
DCOM- 20030403
LR  - 20041117
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 50
IP  - 6
DP  - 2002 Dec
TI  - Mitral valve surgery in patients with poor left ventricular function.
PG  - 351-4
AB  - BACKGROUND: Mitral valve surgery for the correction of secondary mitral valve 
      regurgitation (MR) in cardiomyopathy is associated with a poor outcome. Numerous 
      studies have identified a severe left ventricular dysfunction as an indicator for 
      a poor prognosis. The aim of the study was to asses the follow-up after mitral 
      valve surgery and severe left ventricular dysfunction. METHODS: Between 1994 and 
      2000, 31 patients with mitral regurgitation and a left ventricular ejection 
      fraction of below thirty percent undergoing isolated repair (n = 16) or 
      replacement (n = 15) were investigated. All patients received maximal drug 
      therapy. Twenty-one patients were New York Heart Association (NYHA) class III and 
      10 were class IV. Follow-up with echocardiography, ECG, and chest x-ray was 
      performed in 87 % of the survivors. The mean duration of follow-up was 39 +/- 16 
      months. RESULTS: The mean duration of ICU and hospital stay was 3.6 +/- 2.1 days 
      and 8.1 +/- 5.4 days, respectively. The 1-, 2-, and 5-year survival rates were 91 
      %, 84 %, and 77 %, respectively. NYHA class improved from 3.3 +/- 0.8 to 2.1 +/- 
      0.7 at follow-up (p < 0.01). The ejection fraction improved from 23.1 +/- 6.6 % 
      to 36 +/- 6.8 % at follow-up (p < 0.02). Freedom from readmission for heart 
      failure was 85 %, 79 %, and 68 % at 1-, 2-, and 5 years, respectively. 
      CONCLUSIONS: Mitral valve surgery improves left ventricular function and reduces 
      heart failure severity in patients with MR and cardiomyopathy. High-risk mitral 
      valve surgery may be an alternative to heart transplantation in selected 
      patients.
FAU - Rothenburger, M
AU  - Rothenburger M
AD  - Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, 
      Germany. markus.rothenburger@thgms.uni-muenster.de
FAU - Rukosujew, A
AU  - Rukosujew A
FAU - Hammel, D
AU  - Hammel D
FAU - Dorenkamp, A
AU  - Dorenkamp A
FAU - Schmidt, C
AU  - Schmidt C
FAU - Schmid, C
AU  - Schmid C
FAU - Wichter, T
AU  - Wichter T
FAU - Scheld, H H
AU  - Scheld HH
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Atrial Fibrillation/etiology
MH  - Coronary Artery Bypass
MH  - Female
MH  - Heart Valve Prosthesis
MH  - Humans
MH  - Intra-Aortic Balloon Pumping
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*complications/physiopathology/*surgery
MH  - Postoperative Complications/mortality
MH  - Prognosis
MH  - Risk Factors
MH  - Stroke Volume/physiology
MH  - Survival Rate
MH  - Ventricular Dysfunction, Left/*complications/physiopathology
EDAT- 2002/11/29 04:00
MHDA- 2003/04/04 05:00
CRDT- 2002/11/29 04:00
PHST- 2002/11/29 04:00 [pubmed]
PHST- 2003/04/04 05:00 [medline]
PHST- 2002/11/29 04:00 [entrez]
AID - 10.1055/s-2002-35746 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2002 Dec;50(6):351-4. doi: 10.1055/s-2002-35746.