Mitral valve repair for rheumatic mitral regurgitation: Mid-term results.

Objective: This retrospective study was undertaken to evaluate the midterm results of mitral valve repair for rheumatic mitral regurgitation, in term of survival rate and late valve failure.

Methods: From January 2003 to January 2014, 97 patients underwent mitral valve repair in our hospital. Age ranged from 8 to 74 years, mean 24 ± 1.4 years; 74 (76%) patients were female. Mean preoperative functional class was 2.47 ± 0.07. Mean preoperative ejection fraction was 59.9% ± 2%. The lesions were pure mitral regurgitation in 79 (81.4%) patients, predominant mitral regurgitation with stenosis in 9 (9.3%), and predominant mitral stenosis with regurgitation in 9 (9.3%). Seventy-one (73%) patients were in normal sinus rhythm.

Results: One patient died in the postoperative period, and 8 were lost during follow-up. Follow-up time ranged from 6 to 137 months, mean 58.8 ± 4.2 months. There were 6 late deaths. Actuarial survival at 5 and 10 years was 95.5% and 89.2%, respectively. Twenty-seven (27.8%) patients had mitral regurgitation during follow-up, and 7 underwent reoperation with no hospital mortality. Freedom from reoperation at 5 and 10 years was 94.5% and 82.7%, respectively. Freedom from reoperation or progression of mitral regurgitation at 5 and 10 years was 70.4% and 61.8%, respectively. Freedom from all late events at 5 and 10 years was 68 % and 56.4%, respectively.

Conclusions: Mitral valve repair for rheumatic mitral regurgitation is associated with a significant rate of valve failure and reoperation. However, it has a satisfactory survival rate and is a good alternative to valve replacement, especially for young patients, to avoid the life-long risks of a prosthetic valve.