HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Xavier M. Mueller Hendrik T. Tevaearai Patrick Ruchat Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mueller, X. M. Articles by Segesser, L. v. Search for Related Content PubMed PubMed Citation Articles by Mueller, X. M. Articles by Segesser, L. v.

J Thorac Cardiovasc Surg 1998;115:1298-1302
© 1998 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Long-term results of mitral-aortic valve operations

From the Clinic for Cardiovascular Surgery, CHUV (Centre Hospitalier Universitaire Vaudois), Lausanne, Switzerland.

Received for publication Oct. 21, 1997. Revisions requested Dec. 8, 1997; revisions received Jan. 9, 1997. Accepted for publication Jan. 9, 1998. Address for reprints: X. Mueller, MD, Department of Cardiovascular Surgery, CHUV, CH-1011 Lausanne, Switzerland.

Abstract

Objective: We analyzed the long-term morbidity and mortality of our experience with combined mitral-aortic surgery, as well as their determinants.
Methods: Among 2109 consecutive patients undergoing valve operations, 200 had mitral-aortic valve procedures with at least implantation of a mechanical prosthesis: 163 of 200 (81.5%) patients had double valve replacement and 37 of 200 (18.5%) had mitral valve repair and aortic valve replacement. All mechanical valves were bileaflet prostheses. Preoperatively, 171 of 200 (85.5%) patients were in New York Heart Association class III-IV. Event-free survivals were determined by means of the Kaplan-Meier method and determinants of survivals with the Cox proportional hazards model (p < 0.05) entering 39 preoperative and perioperative factors. Follow-up was complete for 96% of the patients (192/200).
Results: Overall survivals at 5, 10, and 15 years were 88.5% ± 0.55%, 73.5% ± 4%, and 53.3% ± 8.9%, and rates of freedom from valve-related mortality were 92.9% ± 1.5%, 85.8% ± 3.5%, and 85.8% ± 3.5%. The rates of freedom from permanent valve-related impairment were 91.5% ± 1.7%, 85.4% ± 3.5%, and 79.3% ± 6.7%, and those from all valve-related mortality and morbidity were 74.1% ± 2.3%, 53.8% ± 5%, and 49% ± 5.6%. At last follow-up, 90% (139/154) of the survivors were in New York Heart Association class I-II. Left ventricular ejection fraction less than 50%, age older than 70 years, and preoperative ventricular arrhythmias were independent risk factors for valve-related late deaths. Diabetes, ejection fraction less than 50%, and coronary artery disease were independent determinants of all valve-related events.
Conclusions: Functional results of survivors of combined mitral-aortic surgery are excellent. However long-term valve-related morbidity and mortality are substantial. In the patient population studied, the predictors are determined by patient-related factors, mainly myocardial factors, but not by valve-related factors.

This article has been cited by other articles:

				A. Maleszka, G. Kleikamp, A. Zittermann, M. R.G. Serrano, and R. Koerfer Simultaneous Aortic and Mitral Valve Replacement in Octogenarians: A Viable Option? Ann. Thorac. Surg., December 1, 2008; 86(6): 1804 - 1808. [Abstract] [Full Text] [PDF]

				J. Caballero-Borrego, J. J. Gomez-Doblas, F. Cabrera-Bueno, J. M. Garcia-Pinilla, J. M. Melero, C. Porras, E. Olalla, and E. De Teresa Galvan Incidence, associated factors and evolution of non-severe functional mitral regurgitation in patients with severe aortic stenosis undergoing aortic valve replacement. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 62 - 66. [Abstract] [Full Text] [PDF]

				F. Vanden Eynden, D. Bouchard, I. El-Hamamsy, A. Butnaru, P. Demers, M. Carrier, L. P. Perrault, J.-C. Tardif, and M. Pellerin Effect of Aortic Valve Replacement for Aortic Stenosis on Severity of Mitral Regurgitation Ann. Thorac. Surg., April 1, 2007; 83(4): 1279 - 1284. [Abstract] [Full Text] [PDF]

				K. Kuwaki, N. Kawaharada, K. Morishita, T. Koyanagi, H. Osawa, T. Maeda, and T. Higami Mitral Valve Repair Versus Replacement in Simultaneous Mitral and Aortic Valve Surgery for Rheumatic Disease Ann. Thorac. Surg., February 1, 2007; 83(2): 558 - 563. [Abstract] [Full Text] [PDF]

				C. J. Barreiro, N. D. Patel, T. P. Fitton, J. A. Williams, P. N. Bonde, V. Chan, D. E. Alejo, V. L. Gott, and W. A. Baumgartner Aortic Valve Replacement and Concomitant Mitral Valve Regurgitation in the Elderly: Impact on Survival and Functional Outcome Circulation, August 30, 2005; 112(9_suppl): I-443 - I-447. [Abstract] [Full Text] [PDF]

				J.-P. Remadi, O. Baron, C. Tribouilloy, J. C. Roussel, O. Al Habasch, P. Despins, J.-L. Michaud, and D. Duveau Bivalvular mechanical Mitral-Aortic valve replacement in 254 patients: Long-Term results--a 22-year follow-up Ann. Thorac. Surg., August 1, 2003; 76(2): 487 - 492. [Abstract] [Full Text] [PDF]

				B. Absil, F. Dagenais, P. Mathieu, J. Metras, J. Perron, R. Baillot, R. Bauset, and D. Doyle Does moderate mitral regurgitation impact early or mid-term clinical outcome in patients undergoing isolated aortic valve replacement for aortic stenosis? Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 217 - 222. [Abstract] [Full Text] [PDF]

				A. M. Gillinov, E. H. Blackstone, D. M. Cosgrove III, J. White, P. Kerr, A. Marullo, P. M. McCarthy, and B. W. Lytle Mitral valve repair with aortic valve replacement is superior to double valve replacement J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1372 - 1387. [Abstract] [Full Text] [PDF]

				V. H. Thourani, W. S. Weintraub, J. M. Craver, E. L. Jones, E. M. Mahoney, and R. A. Guyton Ten-year trends in heart valve replacement operations Ann. Thorac. Surg., August 1, 2000; 70(2): 448 - 455. [Abstract] [Full Text] [PDF]

				J. Turina, T. Stark, B. Seifert, and M. Turina Predictors of the Long-Term Outcome After Combined Aortic and Mitral Valve Surgery Circulation, November 9, 1999; 100 (2009): II-48 - II-53. [Abstract] [Full Text] [PDF]