Surgical mitral repair for degenerative mitral regurgitation at a high-volume center achieved a 10-year survival of 89.65% (95% CI 88.75-90.55) and 96.63% freedom from reoperation.
Cohort (n=3,317)
No
BACKGROUND There are limited published reports about the long-term outcomes of contemporary surgical mitral repair series for degenerative mitral regurgitation performed at a high-volume center. OBJECTIVES The aim of this study is to report independently adjudicated long-term results of contemporary mitral repair surgery performed at a high-volume center. METHODS A retrospective study was conducted on 3,317 patients who underwent surgical mitral repair for degenerative mitral regurgitation at a tertiary care center between January 1, 2008 and December 31, 2017. Follow-up data, focusing on survival, reinterventions, and heart failure rehospitalizations were adjudicated and analyzed by the Italian National Agency for Regional Healthcare Services. Echocardiographic assessments during follow-up were not included. Complete (100%) data linkage was achieved. RESULTS The median age of the patients was 57 years, and 68.56% were men. The overall in-hospital mortality was 0.48% (16 of 3,317) for all cases and 0.21% (5 of 2,399) in isolated mitral valve repair. The 10-year survival was 89.65% (95% CI: 88.75%-90.55%), independently associated with preoperative symptoms and anterior leaflet disease. Freedom from reoperation was 96.63% (95% CI: 95.63%-97.63%) at 10 years. Anterior leaflet disease, a second run of cardiopulmonary bypass, and more than mild mitral regurgitation at discharge were associated with increased risk of reoperation. Finally, 10-year freedom from rehospitalization for heart failure was 92.24% (95% CI: 90.62%-93.86%), with age, prior hospitalization for heart failure, preoperative symptoms, and anterior leaflet disease identified as independent risk factors. CONCLUSIONS This contemporary series provides further data on the low in-hospital mortality and excellent long-term outcomes of surgical mitral repair when performed in a high-volume center. Preoperative symptoms are associated with worse outcomes. Isolated anterior leaflet disease increases the risk of reoperation, heart failure rehospitalization, and late mortality compared to posterior or bileaflets pathology.
Forno et al. (Wed,) conducted a cohort in Degenerative mitral regurgitation (n=3,317). Surgical mitral repair was evaluated on 10-year survival (95% CI 88.75-90.55). Surgical mitral repair for degenerative mitral regurgitation at a high-volume center achieved a 10-year survival of 89.65% (95% CI 88.75-90.55) and 96.63% freedom from reoperation.