Long-Term Outcomes of Mitral Valve Repair in Degenerative Valve Disease: Comparison Between Posterior and Anterior or Bileaflet Mitral Valve Prolapse

Abstract

Objective: The aim of this study is to compare the clinical and echocardiographic outcome of mitral valve repair secondary todegenerative mitral valve regurgitation in patients with posterior versus anterior or bileaflet mitral valve prolapse.Methods: Between April 1997 and July 2013, 255 patients underwent surgery for moderate to severe degenerative mitral valveregurgitation: 175 had posterior mitral valve prolapse (Group 1) and 80 had anterior or bileaflet mitral valve prolapse (Group2). There were no differences in age or sex between the groups. Clinical follow-up was completed in 95% of the cases witha mean follow-up period of 5.6 ± 3.8 years and 77% completed echocardiographic follow-up with a mean of 4.8 ± 3.7 years.Results: The procedure was successful in 87% of cases (33 intraoperative conversions to mitral valve replacement) (Group1: 98% vs. Group 2: 62.5%; p < 0.01). Overall in-hospital mortality was 2.3% (6/255), and 10-year survival was 92.0 ± 2.1%(Group 1: 94.4% ± 2.2% vs. Group 2: 86.3 ± 5.1%; p = 0.036). At 10-year follow-up, 95.6 ± 1.6% of patients were free fromreoperation (Group 1: 97.1 ± 1.4% vs. Group 2: 89.7 ± 5.0%; p = 0.035), 79.0 ± 4.4% remained free from moderate to severemitral regurgitation (Group 1: 80.8 ± 4.8% vs. Group 2: 71.9 ± 9.6%; p = 0.14) and 91.2% were asymptomatic (92% Group1 vs. 89.3% Group 2; p = 0.5).Conclusions: Patients undergoing mitral valve repair secondary to degenerative posterior mitral valve prolapse had highersurvival and lower incidence or reoperation in the long-term follow-up. There were no differences in freedom from moderateto severe mitral regurgitation between both groups at 10-year follow-up.