Details

Autor(en) / Beteiligte

• Tomšič, Anton
• Hiemstra, Yasmine L.
• van Hout, Fabienne M.A.
• van Brakel, Thomas J.
• Versteegh, Michel I.M.
• Marsan, Nina Ajmone
• Klautz, Robert J.M.
• Palmen, Meindert

Titel

Long-term results of mitral valve repair for severe mitral regurgitation in asymptomatic patients

Ist Teil von

• Journal of cardiology, 2018-12, Vol.72 (6), p.473-479

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2018

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Mitral valve surgery for severe degenerative regurgitation in asymptomatic patients is safe.•Valve repair is feasible regardless of the complexity of lesions causing valve regurgitation.•Early surgery results in life expectancy and quality of life comparable to the general population.•Postoperative supraventricular rhythm disturbances are common and need further investigation. In asymptomatic patients with severe degenerative mitral valve regurgitation (MR), early surgery is often performed in experienced centers. The patient- and valve-related results and the quality of life after surgery in these patients remain insufficiently explored. Between 1/2000 and 12/2015, 83 asymptomatic patients (mean age 56.6±12.6 years, 21 female) without any complications related to long-lasting MR underwent early surgery. Follow-up clinical and echocardiographic data and health-related quality of life assessment (SF-36) were studied and matched to the general population. Repair rate was 100% and early mortality was 0%. Residual MR (≥grade 2+) was seen in 1 (1%) patient who underwent a successful re-repair while 4 (5%) patients needed permanent pacemaker implantation. At a median follow-up of 7.6 (IQR 4.1–11.9) years, 6 late deaths occurred. The 10-year overall survival rate was 91.5% (95% CI 84.2–98.8%) and was comparable to the general population. The health-related quality of life (84% complete) did not differ from the general population. One patient underwent late reintervention. Median echocardiography follow-up was 5.2 years (IQR 2.4–10.4; 98% complete). The 10-year freedom from recurrent MR rate (≥grade 2+) was 86.7% (95% CI 76.1–97.3%). The 10-year freedom from any atrial tachycardia rate was 68.7% (95% CI 55.2–82.2%) while 7 (8%) patients underwent late pacemaker implantation. Early surgical intervention in asymptomatic patients with severe MR can be performed safely and restores normal life expectancy and quality of life. However, the frequency of late arrhythmias and pacemaker implantation is high and needs further evaluation.