Early surgery in patients with mitral regurgitation due to flail leaflets : A long-term outcome study

• Published in: Circulation (New York, N.Y.) N.Y.), 1997-09, Vol.96 (6), p.1819-1825
• Main Authors: LING, L. H, ENRIQUEZ-SARANO, M, SEWARD, J. B, ORSZULAK, T. A, SCHAFF, H. V, BAILEY, K. R, JAMIL TAJIK, A, FRYE, R. L
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Atrial Fibrillation - etiology; Atrial Fibrillation - mortality; Biological and medical sciences; Cardiology. Vascular system; Cause of Death; Echocardiography; Endocardial and cardiac valvular diseases; Endocarditis - etiology; Endocarditis - mortality; Female; Follow-Up Studies; Heart; Heart Failure - etiology; Heart Failure - mortality; Hemorrhage - etiology; Hemorrhage - mortality; Humans; Male; Medical sciences; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Mitral Valve - surgery; Mitral Valve Insufficiency - complications; Mitral Valve Insufficiency - mortality; Mitral Valve Insufficiency - surgery; Prognosis; Survival Analysis; Thromboembolism - etiology; Thromboembolism - mortality; Time Factors; Treatment Outcome
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.6.1819

The optimal timing for surgery in patients with mitral regurgitation is disputed. Because of the frequency of left ventricular dysfunction, which is difficult to predict, early surgery has been recommended, but its potential benefits have not been demonstrated. The outcomes of 221 patients (mean age, 65 +/- 13 years; 71% males) with flail leaflets diagnosed with two-dimensional echocardiography between 1980 and 1989 who were eligible for operation were analyzed. Group I comprised 63 patients who had early mitral valve surgery (within 1 month after diagnosis). Group II comprised 158 patients initially treated conservatively (80 of whom were operated on later). Group I patients were younger (P=.009), had more symptoms (P