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Early and mid-term functional and survival benefits in ischaemic versus degenerative mitral valve repair using Duran flexible ring: a single surgeon series

Department of Cardiothoracic Surgery, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK

*Corresponding author. Tel.: +44 7853304079; fax: +44 2032993433.

E-mail address: profknow171{at}yahoo.com (Z. Makhija).

The late results of ischaemic mitral valve (MV) repair have been less than satisfying. We compared echocardiographically, the changes in LV function, mid-term durability and survival between MV repair caused by ischaemic cardiomyopathy (n=60) with degenerative MV disease (n=73) over a period of 15 years. The duration of mean follow-up was 3.7±4.1 years in the ischaemic group and 3.9±2.9 years in the degenerative group. Freedom from reoperation at seven years was 98.3%±1.5% and 98.9%±2.1%, respectively (P=0.889). At the last follow-up, NYHA functional class I or II was present in 78.4% of patients in the ischaemic group and 80.9% patients in the degenerative group (P=0.347). An improvement in LVEF was noted in both the groups: ischaemic – 41.3±12.7 (pre-op LVEF: 38.8±14.1) and degenerative – 46.5±11.1 (pre-op LVEF: 45.7±11.7) (P=0.014). At seven years, freedom from a cardiac cause of death was statistically similar in the two groups: 93.3%±1.3% and 92.2%±0.6% (P=0.967). In conclusion, the mid-term results of ischaemic MV repair are similar to those obtained for degenerative MV repair. Surgical correction of ischaemic MR results in long-term improved LVEF and comparable outcomes in terms of freedom from reoperation and survival.

Key Words: Ischaemic; Mitral valve; Repair