PMID- 9330167
OWN - NLM
STAT- MEDLINE
DCOM- 19971113
LR  - 20060504
IS  - 0966-8519 (Print)
IS  - 0966-8519 (Linking)
VI  - 6
IP  - 5
DP  - 1997 Sep
TI  - Green Lane Hospital experience with mitral valve repair for prolapse: adverse 
      outcomes for highly symptomatic patients.
PG  - 475-9
AB  - BACKGROUND AND AIMS OF THE STUDY: Valve repair, where suitable, is the preferred 
      option in patients who require mitral surgery. A number of studies have shown 
      excellent long-term results, but most were undertaken in tertiary referral 
      centers with a high throughput of patients. METHODS: We present our experience in 
      60 patients, aged 60 +/- 14 years, undergoing repair between 1984 and 1993. Most 
      patients (83%) were in New York Heart Association (NYHA) class II or III at the 
      time of surgery; 27% had concomitant ischemic heart disease. Almost all (98%) had 
      posterior leaflet repair and 18% had anterior leaflet repair. Eight surgeons each 
      performed a mean of 7.5 operations during this period. RESULTS: The 30-day 
      mortality rate was 3.3%. There were seven late deaths. Five patients underwent 
      reoperation for mitral regurgitation (two early, three late). At six years, 60% 
      of patients were alive, or free of stroke or reoperation. Late follow up was 
      obtained in 45 of 47 surviving patients: 95% were in NYHA class I or II; 
      one-third were on anticoagulants for atrial fibrillation; 90% had mild (or less) 
      mitral regurgitation on echocardiography. CONCLUSIONS: These data show that most 
      patients have a very good outcome from valve repair surgery and encourage the 
      trend towards operating earlier in the course of the disease. Adverse outcomes 
      occurred mainly in patients who were highly symptomatic at the time of surgery. 
      The high proportion of patients on postoperative anticoagulants underscores the 
      importance of operating before atrial fibrillation becomes permanent.
FAU - O'Meeghan, T J
AU  - O'Meeghan TJ
AD  - Department of Cardiology, Green Lane Hospital, Auckland, New Zealand.
FAU - Jaffe, W M
AU  - Jaffe WM
FAU - Raudkivi, P J
AU  - Raudkivi PJ
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Heart Valve Dis
JT  - The Journal of heart valve disease
JID - 9312096
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - Atrial Fibrillation/drug therapy/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/epidemiology
MH  - Mitral Valve Prolapse/*mortality/*surgery
MH  - New Zealand/epidemiology
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 1997/10/23 00:00
MHDA- 1997/10/23 00:01
CRDT- 1997/10/23 00:00
PHST- 1997/10/23 00:00 [pubmed]
PHST- 1997/10/23 00:01 [medline]
PHST- 1997/10/23 00:00 [entrez]
PST - ppublish
SO  - J Heart Valve Dis. 1997 Sep;6(5):475-9.