Actuarial analysis of late results after closed mitral valvotomy

• Published in: The Annals of thoracic surgery Vol. 45; no. 4; pp. 364 - 369
• Main Authors: Molajo, Adeniyi O., Bennett, David H., Bray, Colin L., Brooks, Nicholas H., Rahman, Ali N., Moussalli, Henri, Dark, John F., Faragher, Brian
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1988; Elsevier Science
• Subjects: Actuarial Analysis; Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Endocardial and cardiac valvular diseases; Female; Follow-Up Studies; Heart; Heart Valve Prosthesis; Humans; Male; Medical sciences; Methods; Middle Aged; Mitral Valve - surgery; Mitral Valve Insufficiency - etiology; Mitral Valve Insufficiency - physiopathology; Mitral Valve Stenosis - mortality; Mitral Valve Stenosis - physiopathology; Mitral Valve Stenosis - surgery; Postoperative Complications; Reoperation; Human; Closed heart surgery; Mitral valve; Valvulotomy; Cardiac valvular disease; Surgery; Cardiovascular disease; Narrowing
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(98)90006-6

The long-term results of closed mitral valvotomy performed between 1978 and 1985 in 198 patients with noncalcific mitral stenosis were analyzed. Follow-up data were available on 185 patients (93%); 1 patient died in the postoperative period, and 12 foreign patients were lost to follow-up. At the 4-year and 8-year intervals, 91% and 80% of patients, respectively, were event free (not in need of further operative procedures). By multivariate analysis, the factor preoperative mild mitral regurgitation showed a tendency to influence the event-free period. By univariate analysis, postoperative mitral regurgitation significantly reduced the event-free period. Twenty-one patients subsequently underwent mitral valve replacement; 8 for mitral regurgitation, 10 for mitral stenosis, and 3 for mixed mitral regurgitation and stenosis. By multivariate analysis, the reason for reoperation significantly influenced the length of the event-free period. The patients with mitral regurgitation required mitral valve replacement sooner than those with mitral stenosis. Advanced age, sex, previous valvotomy, preoperative New York Heart Association Functional Class, low mitral valve leaflet excursion, and pulmonary hypertension had no influence on the long-term result.