FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE

Translated title of the contribution: Factors influencing survival after surgery of pure, non-ischaemic mitral regurgitation.

P. L. Michel, Maurice E Sarano, P. Cazaux, J. P. Belot, C. Spaulding, J. M. Jais, C. Plotton, J. Acar

Research output: Chapter in Book/Report/Conference proceedingChapter

4 Citations (Scopus)

Abstract

Uni and multifactorial (Cox) statistical analysis of the results of surgery in a series of 247 patients operated between 1969 and 1988 for pure, non-ischaemic mitral regurgitation was undertaken to determine the factors influencing operative and late mortality. All but 3 cases were adults, average age 51 years, and very symptomatic (75 per cent Class III and IV of NYHA Classification). Dystrophic or degenerative lesions were responsible for 53 per cent of cases of regurgitation whilst rheumatic valvular disease was only observed in 30 per cent of cases. Mitral valve replacement was performed in 137 patients (96 mechanical and 41 bioprostheses) and conservative surgery was possible in 110 cases. There were 12 operative deaths (4.9%); the operative risk increased with age and with the practice of valve replacement. Eleven of the 235 survivors (4.7%) were lost to follow-up. During the follow-up period (average 58 months) there were 37 late deaths of which nearly a half were due to left ventricular dysfunction. Multifactorial analysis identified cardiothoracic ratio and atrial fibrillation as predictive factors of late mortality whilst left ventricular ejection fraction and the type of surgery were related to the development of left ventricular dysfunction. The postoperative left ventricular ejection fraction was significantly lower after valve replacement than after valvuloplasty (11 ± 13% vs 3 ± 13%; p < 0.01). These results are therefore in favour of early correction of severe mitral regurgitation by conservative surgery whenever possible.

Original languageFrench
Title of host publicationArchives des Maladies du Coeur et des Vaisseaux
Pages45-51
Number of pages7
Volume83
Edition1
StatePublished - 1990
Externally publishedYes

Fingerprint

Mitral Valve Insufficiency
Survival
Left Ventricular Dysfunction
Stroke Volume
Bioprosthesis
Mortality
Lost to Follow-Up
Rheumatic Diseases
Mitral Valve
Atrial Fibrillation
Survivors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Michel, P. L., Sarano, M. E., Cazaux, P., Belot, J. P., Spaulding, C., Jais, J. M., ... Acar, J. (1990). FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE. In Archives des Maladies du Coeur et des Vaisseaux (1 ed., Vol. 83, pp. 45-51)

FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE. / Michel, P. L.; Sarano, Maurice E; Cazaux, P.; Belot, J. P.; Spaulding, C.; Jais, J. M.; Plotton, C.; Acar, J.

Archives des Maladies du Coeur et des Vaisseaux. Vol. 83 1. ed. 1990. p. 45-51.

Research output: Chapter in Book/Report/Conference proceedingChapter

Michel, PL, Sarano, ME, Cazaux, P, Belot, JP, Spaulding, C, Jais, JM, Plotton, C & Acar, J 1990, FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE. in Archives des Maladies du Coeur et des Vaisseaux. 1 edn, vol. 83, pp. 45-51.
Michel PL, Sarano ME, Cazaux P, Belot JP, Spaulding C, Jais JM et al. FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE. In Archives des Maladies du Coeur et des Vaisseaux. 1 ed. Vol. 83. 1990. p. 45-51
Michel, P. L. ; Sarano, Maurice E ; Cazaux, P. ; Belot, J. P. ; Spaulding, C. ; Jais, J. M. ; Plotton, C. ; Acar, J. / FACTEURS INFLUENCANT LA SURVIE APRES CHIRURGIE DE L'INSUFFISANCE MITRALE PURE NON ISCHEMIQUE. Archives des Maladies du Coeur et des Vaisseaux. Vol. 83 1. ed. 1990. pp. 45-51
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abstract = "Uni and multifactorial (Cox) statistical analysis of the results of surgery in a series of 247 patients operated between 1969 and 1988 for pure, non-ischaemic mitral regurgitation was undertaken to determine the factors influencing operative and late mortality. All but 3 cases were adults, average age 51 years, and very symptomatic (75 per cent Class III and IV of NYHA Classification). Dystrophic or degenerative lesions were responsible for 53 per cent of cases of regurgitation whilst rheumatic valvular disease was only observed in 30 per cent of cases. Mitral valve replacement was performed in 137 patients (96 mechanical and 41 bioprostheses) and conservative surgery was possible in 110 cases. There were 12 operative deaths (4.9{\%}); the operative risk increased with age and with the practice of valve replacement. Eleven of the 235 survivors (4.7{\%}) were lost to follow-up. During the follow-up period (average 58 months) there were 37 late deaths of which nearly a half were due to left ventricular dysfunction. Multifactorial analysis identified cardiothoracic ratio and atrial fibrillation as predictive factors of late mortality whilst left ventricular ejection fraction and the type of surgery were related to the development of left ventricular dysfunction. The postoperative left ventricular ejection fraction was significantly lower after valve replacement than after valvuloplasty (11 ± 13{\%} vs 3 ± 13{\%}; p < 0.01). These results are therefore in favour of early correction of severe mitral regurgitation by conservative surgery whenever possible.",
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