PMID- 19119588
OWN - NLM
STAT- MEDLINE
DCOM- 20090129
LR  - 20090105
IS  - 0743-6661 (Print)
IS  - 0743-6661 (Linking)
VI  - 40
IP  - 2
DP  - 2008
TI  - Mitral valve repair: late mortality, favorable and unfavorable characteristics.
PG  - 100-9
AB  - OBJECTIVES: Review late mortality experience associated with surgical repair of 
      regurgitant myxomatous mitral valves. Identify mortality associated with 
      favorable and unfavorable characteristics for surgical mitral valve repair (MVR). 
      METHODS: Overall mortality associated with MVR reported by several North American 
      centers since 1980 is assessed. Mortality from additional studies on MVR 
      associated with favorable and unfavorable preoperative characteristics is also 
      determined. Standard mortality methodology is used and expectant mortality 
      determined from the appropriate population life tables. RESULTS: Averaged 
      (weighted for numbers of entrants) overall morality ratios (MR) for MVR from the 
      Mayo Clinic and University of Toronto at 5, 10, and 15 years were 106%, 113% and 
      145%. Favorable characteristics included isolated posterior leaflet repairs (MR 
      at 5, 10 and 15 years: 97%, 106% and 130%) and asymptomatic preoperative status, 
      defined as New York Heart Association (NYHA) Functional Class I or II (MR at 5, 
      10 and 15 years: 69%, 50% and 93%). Unfavorable characteristics included isolated 
      anterior mitral leaflet repairs (MR: 202%, 212% and 188%) and preoperative 
      symptomatic NYHA Functional Class III or IV (MR: 142%, 130% and 127%). When 
      reoperation was required, mild or moderate underlying myxomatous degeneration was 
      favorable, usually enabling re-repair (MR at 12 years: 77%). Reoperation when 
      severe myxomatous degeneration was present usually required prosthetic valve 
      insertion (MR at 12 years: 187%). Coronary artery bypass grafting done at the 
      time of MVR demonstrates an associated minimal increase in late mortality. 
      CONCLUSIONS: Surgical repair of myxomatous mitral valves produces durable 
      long-term results with mild to modest overall increases in mortality. Favorable 
      preoperative characteristics may be associated with near standard mortality risk.
FAU - Lund, Robert W
AU  - Lund RW
AD  - Munich American Reassurance Company (MARC), 56 Perimeter Center East, Atlanta, GA 
      30346-2290, USA. rlund@marclife.com
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Insur Med
JT  - Journal of insurance medicine (New York, N.Y.)
JID - 8401468
MH  - Cardiac Surgical Procedures/classification/*mortality
MH  - Coronary Artery Bypass/mortality
MH  - Female
MH  - Health Status
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*mortality/*surgery
MH  - Reoperation
MH  - Risk Assessment
RF  - 16
EDAT- 2009/01/06 09:00
MHDA- 2009/01/30 09:00
CRDT- 2009/01/06 09:00
PHST- 2009/01/06 09:00 [entrez]
PHST- 2009/01/06 09:00 [pubmed]
PHST- 2009/01/30 09:00 [medline]
PST - ppublish
SO  - J Insur Med. 2008;40(2):100-9.