Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications

摘要: Abstract Objective: This study reviews the 223 consecutive mitral valve operations for ischemic insufficiency performed at New York University Medical Center between January 1976 and 1996. The results reconstruction are compared with those prosthetic replacement. Methods: From to 1996, patients underwent (n = 152) or replacement 71). Coronary artery bypass grafting was in 89% of cases 80% In group undergoing reconstruction, 77% had valvuloplasty a ring annuloplasty 23% suture annuloplasty. replacement, 82% received bioprostheses 18% mechanical prostheses. Results: Follow-up 93% complete (median 14.6 mo, range 0-219 mo). Thirty-day mortality 10% 20% short-term higher among Heart Association functional class IV than classes I III (odds ratio 5.75, confidence interval 1.25-26.5) reduced angina relative without 0.26, 0.05-1.2). 30-day death complication rate similarly elevated 5.53; 1.23-25.04). Patients lower rates did 0.43, 0.20-0.90). Eighty-two percent no only trace during long-term follow-up period. Five-year complication-free survivals were 64% (confidence 54%-74%) 47% 33%-60%) Results series statistical analyses suggest that outcome linked primarily preoperative class. Conclusions: Initial mortalities similar reconstruction. Poor related preexisting comorbidities. fewer valve-related complications. Valve resulted excellent durability freedom from These findings should be considered appropriate insufficiency.